AFRICAN-AMERICAN STUDY OF KIDNEY DISEASE AND HYPERTENSION (AASK)

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试验是一项随机临床试验，测试了作为一线降压药物的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(通常控制和更积极的控制)对肾脏疾病的影响。AASK队列研究招募了参加过AASK临床试验的受试者。暴露包括环境、遗传、生理和社会经济因素。原发肾脏结局是以血肌酐加倍、终末期肾病(ESRD)或死亡为定义的临床结局。与确定暴露和监测结果有关的数据在基线和此后每12个月收集一次。在这些就诊和每年另外2至4次就诊中进行抗高血压治疗的管理。核心测量包括：血压、空腹血样、DNA、24小时尿液采集、指甲(重金属)、问卷和心血管程序(心电图；二维、M型、脉冲多普勒和脉冲组织多普勒超声心动图；24小时动态血压记录)。向所有没有ESRD的参与者提供适当的降压治疗(AASK试验中确定的药物和目标血压水平)。通过这种方式，队列直接控制肾脏疾病进展的两个主要的“已知”决定因素(高血压的控制和肾脏保护性抗高血压药物的使用)，因此解决了在推荐的抗高血压治疗的背景下的研究问题。队列研究的预期随访期为5年(总计9-12年，包括AASK试验期间)。一个独立的dsmb监测研究的各个方面，并审查所有不良事件。最终，来自AASK队列研究的数据应该会加强我们对决定肾脏疾病进展的过程的理解。这项研究的成功完成还可能导致新的预防策略，推迟ESRD的发病。

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 trial was a randomized, clinical trial that tested the effects on kidney disease of 3 different medications used as first line antihypertensive therapy (ramipril, metoprolol and amlodipine) and 2 levels of blood pressure control (usual control and more aggressive control). The AASK Cohort Study enrolled subjects who had participated in the AASK clinical trial. Exposures include environmental, genetic, physiologic, and socio-economic factors. The primary renal outcome is a clinical outcome defined by doubling of serum creatinine, end-stage renal disease (ESRD) or death. Data related to ascertainment of exposures and surveillance of outcomes are collected at baseline and every 12 months thereafter. Management of antihypertensive therapy occurs at these visits and at an additional 2 to 4 visits/year. Core measurements include the following: blood pressure, fasting blood specimens, DNA, 24-hour urine collection, finger nails (for heavy metals), questionnaires and cardiovascular procedures (ECG; 2 dimensional, M-mode, pulsed Doppler and pulsed tissue Doppler echocardiogram; and 24-hour ambulatory BP recordings). Appropriate antihypertensive treatment (medications and target BP level as determined in the AASK trial) is provided to all participants who do not have ESRD. In this fashion, the cohort directly controls two of the major 'known' determinants of kidney disease progression (control of hypertension and use of reno-protective, antihypertensive medication) and therefore addresses research questions in the setting of recommended antihypertensive care. The anticipated duration of follow-up in the Cohort Study is 5 years (total of 9-12 years, including the period of the AASK trial). An independent DSMB monitors all aspects of the study, and reviews all adverse events. Ultimately, data from the AASK cohort study should enhance our understanding of the processes that determine progression of renal disease. Successful completion of this study might also lead to new prevention strategies that delay the onset of ESRD.