One such trial that will evaluate this question is Systolic Blood Pressure Intervention Trial (SPRINT) which is funded by National Institutes of Health (NIH).171,172 It will evaluate cardiovascular and kidney outcomes in patients randomized to a systolic BP of o140 mm Hg versus o120 mm Hg. There is a CKD component for patients with GFR 20 60 ml/min/ . Patients with diabetes and those with 24-hour urine protein excretion of 41 g per 24 hours are excluded from this study. 3.4: We suggest that an ARB or ACE-I be used in non- diabetic adults with CKD ND and urine albumin excretion of 30 to 300 mg per 24 hours (or equivalent*) in whom treatment with BP-lowering drugs is indicated. (2D) *Approximate equivalents for albumin excretion rate per 24 hours expressed as protein excretion rate per 24 hours, albumin/creatinine ratio, protein/creatinine ratio, and protein reagent strip results are given in Table 1, Chapter 1. RATIONALE K Urine albumin excretion of 30 to 300 mg per 24 hours (microalbuminuria) is a risk factor for CVD and CKD progression. K ACE-Is and ARBs have been shown to reduce urine albumin levels. K RCTs suggest that ACE-Is or ARBs may help reduce progression of CKD and possibly CVD in patients with urine albumin excretion of 30 to 300 mg per 24 hours. As mentioned above, patients with microalbuminuria are at high risk for both progression of CKD and development of Here, we describe the trial data which either focused on kidney disease or CVD outcomes. Some trials focused on both.173176 Kidney disease. In AASK, a study of patients with a PCR o220 mg/g (o22 mg/mmol), the ACE-I ramipril decreased the urine protein level. 