CHARLESTON STUDY OF KIDNEY DISEASE IN AFRICAN AMERICANS

65例18-70岁患有高血压肾的非洲裔美国人 疾病将被随机分配到治疗4年， 血管紧张素转化酶抑制剂、钙通道阻滞剂或 β受体阻滞剂作为一线抗高血压药物， 血压控制水平的判断：1）是否治疗高血压 减缓肾功能不全的进展; 2）是否是三种之一 药物提供了一个特定的肾脏保护作用;和3）是否控制 血压降至较低水平可更大程度地保护肾功能。 英国石油公司将 至少每月进行一次监测和药物调整，以监测患者 遵守和不利影响，并确保指定的BP目标 办妥了一批肾小球滤过率将每季度测量一次， [125 I]-碘酞酸盐的血浆消失。 将招募受试者 来自南卡罗来纳州医科大学的诊所， 家庭保健诊所、SC卫生部、私人医生、 当地教堂和社区高血压筛查项目。 研究 将在当地通过电视、广播、报纸、海报 给医生的信 鼓励受试者参与， 确保保留和依从性，将在研究中心进行研究访视 方便约翰斯市中心查尔斯顿的目标人群 在Yonges岛，使用Fetter诊所设施， 家庭保健中心以及综合临床研究中心 （GCRC）在MUSC。 交通将提供。 全职护士 协调员和数据办事员将协调预约的时间安排， 确保患者的随访。 有经验的药剂师将协助 药物分发、跟踪和记录。 当地临床 通过GCRC实验室、MUSC安排了实验室备份 临床实验室和Fetter临床实验室。 数据收集 通过使用GCRC Prophet计算机， 与NIH和研究使用的PC联网的资源 人员的

Sixty-five African Americans aged 18-70 years with hypertensive kidney disease will be randomized to treatment for 4 years with either an angiotensin converting enzyme inhibitor, a calcium channel blocker or a beta-blocker as a first line antihypertensive drug, and to one of two levels of BP control to determine: 1) whether treatment of hypertension slows progression of renal insufficiency; 2) whether one of the three drugs offers a specific reno-protective effect; and 3) whether control of BP to a lower level protects renal function to a greater degree. BP will be monitored and medications adjusted at least monthly to monitor patient compliance and adverse effects and to ensure that assigned BP goals are achieved. Glomerular filtration rate will be measured quarterly as the plasma disappearance of [125I]-iothalamate. Subjects will be recruited from clinics at the Medical University of South Carolina (MUSC), Fetter Family Health Clinics, the SC Department of Health, private physicians, local churches, and community hypertension screening programs. The study will be publicized locally using television, radio, newspapers, posters, and letters to physicians. To encourage subject participation and to ensure retention and compliance, study visits will be performed at sites convenient to the target population in downtown Charleston, on Johns Island and on Yonges Island, using the clinic facilities of the Fetter Family Health Centers, as well as the General Clinical Research Center (GCRC) at MUSC. Transportation will be provided. A fulltime nurse coordinator and data clerk will coordinate scheduling of appointments and ensure followup of patients. An experienced pharmacist will assist with medication distribution, tracking, and documentation. Local clinical laboratory backup has been arranged through the GCRC laboratory, the MUSC Clinical Laboratory and the Fetter Clinic Laboratories. Data collection and management will be facilitated by the use of the GCRC Prophet computer resource which is networked to the NIH and to PCs used by the study personnel.