End-stage Renal Disease in African-American and White Men

Transforming growth factor-beta 1 hyperexpression in African-American hypertensives: A novel mediator of hypertension and/or target organ damage

“…Perry et al (8) have noted a 2-fold higher risk of ESRD among black hypertensives compared with their white counterparts. The Multiple Risk Factor Intervention Trial study has shown that for every level of blood pressure control, blacks are at an increased risk for the development of renal disease compared with whites with the same blood pressure (6). These observations together suggest that other risk factor(s), in addition to hypertension, contribute to hypertension-associated renal disease in blacks.…”

“…End-stage renal disease (ESRD), a devastating medical illness of extraordinary personal suffering and societal costs, is four times more frequent in blacks, and ESRD attributable to hypertension is 20 times more frequent in blacks (5). Data from the Multiple Risk Factor Intervention Trial demonstrated that for every level of blood pressure control, blacks are at increased risk for the development of renal disease (6). Finally, and perhaps most disturbing, are the observations that aggressive blood pressure control has not uniformly led to similar renal-protective benefits in blacks and whites (7,8).…”

Treatment of stage I hypertension and development of renal dysfunction

“…[9][10][11] In spite of this, only a small minority of patients with essential hypertension develop progressive renal insufficiency, but the incidence of renal insufficiency does rise progressively with every 10 mm Hg increment in systolic pressure. 2,12 African-American patients and those with diabetes have a higher likelihood of developing progressive renal disease than the general population. [12][13] Often end-stage renal disease (ESRD) in African-Americans is attributed to hypertensive nephrosclerosis.…”

“…2,12 African-American patients and those with diabetes have a higher likelihood of developing progressive renal disease than the general population. [12][13] Often end-stage renal disease (ESRD) in African-Americans is attributed to hypertensive nephrosclerosis. This might be due to poor hypertension control related to limited access to health care or some other factors.…”

“…This might be due to poor hypertension control related to limited access to health care or some other factors. 12 However, retrospective analyses of clinical trials indicate that renal function may continue to decline in African-Americans even when hypertension is as well controlled as in whites. 12 This data has prompted the multi-centred, double-blind placebo controlled trial, the African-American Study of Kidney Disease (AASK), to evaluate the effects of both level of blood pressure control and type of antihypertensive agents used to achieve such levels on progression of renal disease.…”