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Renal Disease in Hypertensive Blacks: MRFIT-Reply

W. Gordon Walker, MD; James D. Neaton, PhD; Jeffrey A. Cutler, MD; Jerome D. Cohen, MD; Rachel Neuwirth, MS
JAMA. 1993;269(20):2630. doi:10.1001/jama.1993.03500200043030.
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In Reply.  —This study provided a clear answer to the two questions prompting the study: It showed that one in 20 MRFIT participants with mild to moderate hypertension (DBP, 90 to 115 mm Hg) lost renal function at a rate placing them at substantial risk for the development of end-stage renal disease; furthermore, treatment that reduced diastolic pressure lower than 95 mm Hg removed this risk. The identification of risk associated with this hypertensive group and the recognition that the risk appears to be removed by adequate treatment are findings with important implications for prevention of hypertension-related end-stage renal disease.1Failure to demonstrate benefit from treatment among blacks is a finding of concern and importance. The numbers of blacks in this group were not small compared with data previously available,2 and the findings cited above persisted after controlling for possibly confounding factors. Differences in mean reciprocal creatinine slope


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