Among patients with unstable angina or myocardial infarction without ST-segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.).

Digoxin did not reduce overall mortality, but it reduced the rate of hospitalization both overall and for worsening heart failure. These findings define more precisely the role of digoxin in the management of chronic heart failure.

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SUMMARYThe interrelationships of arterial pressure, plasma volume (PV), and plasma renin activity were studied in 152 consecutive male patients with uncomplicated essential hypertension. Of these, 22 (17 white and 5 black) subjects had normal plasma volumes and because of tbe small number were not included in the analysis of results. Tbe remaining 130 (35 black and 95 white) patients were classified as having either expanded or contracted plasma volume. A higher percentage of black (43%) than white (21%) subjects were volume expanded (PV > 19 ml/cm) and a lower percentage of blacks (57%) than whites (79%) were volume contracted (PV < 17 ml/cm). There was no significant difference in mean arterial pressure and plasma renin activity between tbe volume expanded and contracted black patients. In contrast, the white patients with contracted plasma volume had significantly higher arterial pressures (p < 0.05) and plasma renin activity (p < 0.001) than those with expanded plasma volume. More blacks than whites had low plasma reoin activity and did not manifest the inverse relationship of plasma renin activity to plasma volume as did the whites. These data conflnn and extend previous observations that the relationship between plasma volume and plasma renin activity (PRA) in the male patient with essential hypertension seems to differ between the black and white race. Efforts to explain tbe low PRA in black patients might be best directed toward those patients with suppressed PRA and with contracted intravascular volume. (Hypertension 1: 136-141, 1979) KEY WORDS • racial differences • essential hypertension • plasma volume plasma renin activity T HE incidence of essential hypertension is higher in the black than the white race, 1 and more blacks than whites have low renin hypertension. 85 The cause(s) for these racial differences are not clearly understood. Explanations offered for these differences include: the high-salt intake by blacks," 17 the higher incidence of plasma volume expansion in black subjects" and the attenuated response of renin release to various stimuli in blacks."' '•" Besides race, other investigators have