Few trials also tested active comparators to RASi (e.g., AASK, IDNT). There is sparse evidence of the effect of antihypertensive agents other than RASi on clinical outcomes in the setting of CKD with high BP and severely increased proteinuria, with the exception of AASK and IDNT. A number of smaller trials assessed changes Start here: At randomization visit, begin with 2- or 3-drug therapy* using a combination of a thiazide-type** diuretic, and/or an ACEI or ARB (but not both) and/or a CCB Include -blocker or other agents as appropriate for compelling indication Monitor as designated through follow-up Is SBP 120 mm Hg this visit? Is DBP 100 mm Hg at this visit or is DBP 90 mm Hg on last 2 visits? Is this a milepost visit? Yes Yes Yes No No No You must: (a) Add therapy not already in use and (b) See participant monthly until SBP <120 mm Hg You must: (a) Titrate or add therapy not already in use and (b) See participant monthly until SBP <120 mm Hg You must: Titrate or add therapy not already in use Continue therapy Figure 5 | SPRINT research treatment algorithm for the intensive group (goal SBP <120 mm Hg). From The New England Journal of Medicine, the SPRINT Research Group, A Randomized Trial of Intensive Versus Standard Blood-Pressure Control, Volume 373, Pages 2103 2116, Copyright 2015 Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.93 *May begin with a single agent for participants aged $75 years with SBP <140 mm Hg on 0 1 medications at study entry. A second medication should be added at the 1-month visit if participant is asymptomatic and SBP $ 130 mm Hg. **May use loop diuretic for participants with advanced CKD. Unless side effects warrant change in therapy. 