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March 5, 2003

Antihypertensive Drugs and Renal Protection

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(9):1102-1103. doi:10.1001/jama.289.9.1102-a

To the Editor: Dr Wright and colleagues of the AASK trial1 found that among patients with hypertensive kidney disease, the rate of decline in glomerular filtration rate (GFR) was unaffected by either degree of blood pressure (BP) control or by class of antihypertensive agent. However, they did find that patients who received ramipril had a lower risk of a clinical composite outcome than did those who received either amlodipine or metoprolol. A previous report of the AASK trial2 found that ramipril improved renal survival compared with amlodipine at 3-year follow-up, and thus the amlodipine arm was terminated for an ethical reason. We are disappointed that the authors did not report any comparisons between participants receiving amlodipine but with different degrees of BP control.

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