ObjectivesCollaboration of Medical Associations Representing Improving Minority Health:The Problems:RaceRecommended StategiesStrategies
IOMPrevention, Remission, and Regression Strategies inEnriching Medical DiscoveryEnriching Medical DiscoveryEnriching Medical DiscoveryEnriching Medical DiscoveryEnriching Medical DiscoveryEnriching Medical DiscoveryEnriching Medical DiscoveryPercentage of Children and Adults Life Expectancy at Birth by Sex and Prevalence of Overweight Among Prevalence of Overweight Among Children in Grades 5, 7, and 9, Los Angeles County, 2001Homicide Rate Homicide Rate for Los Angeles County Health Indicator Rankings, South and West SPA’s: Examples of Geographic ClusteringPrevalence of Asthma in Children (?17 years old) MapHealth, Race, Gender and Economic StatusWhat can we do?Biologic Differences Among African American and Caucasian PopulationsSerum TGFß1 Levels in Normo- and Hypertensive Black and White Subjects (ng/mL)Differences in PTH-Vit. D Bone Metabolism in Black and White Normal SubjectsSignificant Correlations?Are There Gaps in Clinical Research?Kidney Disease in the U.SESRD Incidence Rate per Million, by Race (2000)The Prevalence of Kidney Disease Is Increasing in All Ethnic GroupsAfrican Americans Have a Disproportionately High Risk Example of Disparities in Health Care Incident Rates of ESRD By Race Ethnicity & Primary Diagnosis*Pre-ESRD Patients Far Outnumber ESRD PatientsEstimates of U.S. CKD PopulationThere Are Many Risk Factors Associated With Kidney Disease
Incidence of ESRD by CauseWorldwide Rates of Diabetes MellitusAdditional Factors Contribute to the High Rate of Kidney Disease in African AmericansTreatment Considerations in CKDPotentially Modifiable Risk Factors for Development and Progression of Chronic Kidney DiseaseEvolution of Cardiovascular RiskAtherosclerosis Begins in ChildhoodHypertension Awareness, Treatment, Lowering BP Reduces CV ComplicationsPrevalence of HypertensionCharacteristics of Hypertension in Complications Related to HypertensionConsensus StatementConsensus StatementConsensus StatementConsensus StatementJNC 7 (2003)Relative Risk Reduction
SBP Reductions
Benefits of BP Control in Type 2 Diabetes:Progression of Renal DiseaseDisease Progression in Type 2 DMMicroalbuminuria and Hypertension Increase the Risk of Ischemic Heart DiseaseEffect of ACE Inhibition on Nephropathy in Type 1 DiabetesEffects of Ang II on IRMA 2: Normalization* of UAER
IDNT: Relationship of Baseline and Change in Proteinuria on Renal Outcomes*
Reduction in Proteinuria
The Role of Angiotensin IIWhy Inhibit the RAAS?Oxidative Stress Is an Unavoidable Consequence of Living in AirStructure of the NAD(P)H OxidaseNitric Oxide and Vasodilation Oxidative StressHyperglycemia Increases in ROSLosartan Prevents Endothelial Dysfunction Induced by Angiotensin II-Mediated Hypertension
Angiotensin II Induces Superoxide Production In Human Vascular TissueEmerging Pathogenic Effects of Angiotensin IIIdeal Risk Factor Values
Miller M, Vogel RHaynes SG et al, Am J Epidemiol 1983;181:1Friedman E, AJC 1995;76:1213To Prevent Kidney DiseaseQuoteCan We Prevent Renal Failure inCan We Prevent Renal Failure inCan We Prevent Renal Failure inCan We Prevent Renal Failure inStrategies for Kidney DiseaseCalcitriol and PTH in 150 Patients at Various Stages of CKD
NKF Kidney Disease Outcomes Quality Initiative CKD Classification
Randall Maxey, M.D., Ph.D.