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AASK
About the Trial
The African American Study of Kidney Disease and Hypertension randomized 1,094 African Americans with hypertensive kidney disease to ramipril, amlodipine, or metoprolol, and to strict versus standard blood pressure targets. Ramipril reduced the composite of dialysis, death, or GFR decline by 22 percent versus metoprolol and 38 percent versus amlodipine, most strongly in proteinuric patients. Strict blood pressure control showed no additional kidney benefit, though long term follow up suggested a kidney benefit in patients with proteinuria. The trial demonstrated renoprotection with ACE inhibition in the population with the highest hypertensive kidney disease burden. AASK findings anchor RAAS blockade as kidney protective regardless of ethnicity.
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