This Article Extract Full Text (PDF) All Versions of this Article: 53/1/e4    most recent HYPERTENSIONAHA.108.125328v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kaplan, N. M. Search for Related Content PubMed Articles by Kaplan, N. M. Related Collections Clinical Studies

(Hypertension. 2009;53:e4.)
© 2009 American Heart Association, Inc.

Letters to the Editor

Response to Uncritical Acceptance of Combination Treatment of Angiotensin II Receptor Blocker and Angiotensin-Converting Enzyme Inhibitor in Nondiabetic Renal Disease Trial Results

Hypertension Division, Department of Internal Medicine, University of Texas, Dallas, Tex

The reason Griffin and Bidani¹ were cited among "the expert nephrologists who have accepted the results of the Combination Treatment of Angiotensin II Receptor Blocker and Angiotensin-Converting Enzyme Inhibitor in Nondiabetic Renal Disease Trial"² was this statement in their 2006 paper³: "Data have been interpreted as indicating that the superior renoprotection that is seen with RAS blockade is mediated by BP-independent mechanisms. Support for such conclusions also has been inferred from the greater benefits that are obtained with dual RAS blockade compared with monotherapy with either ACE inhibitors or ARB. However, with exception of the Combination Treatment of Angiotensin-II Receptor blocker and Angiotensin-converting-Enzyme Inhibitor in Nondiabetic Renal disease (COOPERATE) trial, which did include a small number of hard end points, most of the other smaller studies have shown improvements only in proteinuria and usually not without additional BP reductions." Maybe the good doctors did not intend to accept the COOPERATE data, but it sure looks that way to me.

Bidani’s⁴ questioning of the veracity of the Combination Treatment of Angiotensin II Receptor Blocker and Angiotensin-Converting Enzyme Inhibitor in Nondiabetic Renal Disease data, published some months after the article I quoted, does appear to be the first published questioning of the data, for which we are all grateful.

	Acknowledgments

 
Disclosures

None.

	References

Top References

 
1. Griffin KA, Bidani AK. Uncritical acceptance of Combination Treatment of Angiotensin II Receptor Blocker and Angiotensin-Converting Enzyme Inhibitor in Nondiabetic Renal Disease Trial results. Hypertension. 2009; 53: e3.[Free Full Text]

2. Kaplan NM. Recent clinical trials: the good, the bad, and the misleading. Hypertension. 2008; 52: 608–609.[Free Full Text]

3. Griffin KA, Bidani AK. Progression of renal disease renoprotective specificity of renin-angiotensin system blockade. Clin J Am Soc Nephrol. 2006; 1: 1054–1065.[Abstract/Free Full Text]

4. Bidani A. Controversy about COOPERATE ABPM Trial Data. Am J Nephrol. 2006; 26: 629–632.[CrossRef][Medline] [Order article via Infotrieve]

This Article Extract Full Text (PDF) All Versions of this Article: 53/1/e4    most recent HYPERTENSIONAHA.108.125328v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kaplan, N. M. Search for Related Content PubMed Articles by Kaplan, N. M. Related Collections Clinical Studies