INTENSIVE BP CONTROL AND RENAL DISEASE PROGRESSION

Does good control of Blood pressure, stop end stage renal disease ( ESRD )? Many of us will think that good BP control in hypertensives will halt ESRD. Well the just completed American Hypertension Society annual scientific meeting in New Orleans, was informed that in African Americans, that was not so. Dr J Wright of Cleveland reported on the 11year followup of the African American Study on Kidney diseases ( AASK ). This was a study on the of African Americans with hypertension, who had received ACE-I and now ARBs. Dr Wright was able to report on about 1000 patients who were still on followup for 11years. They found that even with intensive BP lowering till <130/80mmHg, with ACE-I or ARBs, the progression to ESRD continued. There was some slowing down but the development of ESRD was not halted. This is interesting. Looks like good BP control may not allow us to avoid ESRD. It is true that this study was done with African American, and whether or not the results can be extrapolated to our local population, I do not know. That is why, it is important for us, to do our own local research, and not just to accept American study results.