AASK-CO

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。AASK队列研究是一项前瞻性、观察性研究，是AASK临床试验的延伸。AASK试验是一项随机临床试验，测试了作为一线高血压治疗的3种不同药物(雷米普利、美托洛尔和氨氯地平)和2种血压控制水平(通常和更积极的控制)的效果。在AASK的1094名随机参与者中，估计霍华德大学将在AASK队列研究中招募29名(在AASK临床试验中没有达到ESRD的657-750名患者)。此外，达到ESRD的AASK参与者将被邀请参加一次DNA采集。AASK队列研究中的人群每年收集两次暴露，包括环境、遗传、生理和社会经济因素。主要的肾脏结果将是一个临床结果，其定义是血肌酐增加一倍，进展为终末期肾病或死亡。将为所有没有ESRD的参与者提供适当的降压治疗(由AASK试验确定的药物和目标血压水平)。通过这种方式，该队列将直接控制肾脏疾病进展的两个主要的“已知”决定因素(高血压的治疗和肾脏保护性抗高血压药物的使用)，因此，将在推荐的高血压护理的背景下解决其研究目标。预计每个参与者每年将进行最少4次、最多6次的BP控制接触。队列研究的预期随访期为5年(总计9-12年，包括AASK试验)，AASK队列研究将提供数据，增强我们对决定肾脏疾病进展的过程的理解。此外，这项研究的数据可能最终导致新的预防策略，延迟或防止ESRD的发生。尽管良好的血压控制和肾脏保护性降压药物的使用，高血压相关的肾脏疾病通常会进展。AASK队列研究的主要目标是前瞻性地确定患有高血压相关肾病并接受推荐抗高血压治疗的非裔美国人肾脏功能的长期病程和肾脏疾病进展的风险因素。第二个目标是确定心血管疾病的发生，并在高血压相关肾脏疾病的背景下评估其危险因素。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The AASK Cohort Study is a prospective, observational study that is an extension of the AASK Clinical trial. The AASK trial was a randomized, clinical trial that tested the effects of 3 different medications used as first line hypertensive therapy (ramipril, metoprolol and amlodipine) and 2 levels of BP control (usual and more aggressive control). Of the 1,094 randomized participants in AASK, it is estimated that Howard University will enroll 29 (of the 657-750 individuals who did not reach ESRD in the AASK Clinical Trial) in the AASK Cohort Study. Additionally, those AASK participants who reached ESRD will be invited to attend one visit for collection of DNA. Exposures to be collected twice/year for those in the AASK Cohort Study include environmental, genetic, physiologic and socioeconomic factors. The primary renal outcome will be a clinical outcome defined by the doubling of serum creatinine, progression to ESRD or death. Appropriate antihypertensive treatment (medications and target BP levels as determined by the AASK trial) will be provided to all participants who do not have ESRD. In this fashion, the Cohort will directly control two of the major "known" determinants of kidney disease progression (treatment of hypertension and use of reno-protective, antihypertensive medications) and will, therefore, address its research objectives in the setting of recommended hypertensive care. It is anticipated that a minimum of 4 and a maximum of 6 contacts for BP control will take place per year for each participant. The anticipated duration of followup in the Cohort Study will be 5 years (total of 9-12 years, including the AASK Trial), and that the AASK Cohort Study will provide data that enhances our understanding of the processes that determine progression of renal disease. Furthermore, data from this study might ultimately lead to new prevention strategies that delay or prevent the onset of ESRD. Despite excellent BP control and use of reno-protective antihypertensive medication, hypertension-related renal disease commonly progresses. The primary objective of the AASK Cohort Study is to prospectively determine the long-term course of kidney function and risk factors for kidney disease progression in African Americans with hypertension-related kidney disease who receive recommended antihypertension therapy. A secondary objective is to determine the occurrence of cardiovascular disease and assess its risk factors in the setting of hypertension-related kidney disease.