a Current recommended evidence-based dose that balances efficacy and safety is 25-50 mg daily. Clinical Review & Education Special Communication 2014 Guideline for Management of High Blood Pressure E8 JAMA Published online December 18, 2013 jama.com Therefore,thisevidencewasextrapolatedfromfindingsintheblack port comes from a post hoc analysis of black participants in ALL- However,thisstudydidnotmeetthecriteriaforour reviewbecauseitwasaposthocanalysis.Thisrecommendationalso doesnotaddressblackpersonswithCKD,whoareaddressedinrec- ommendation 8. In the population aged 18 years or older with CKD and hyperten- sion, initial (or add-on) antihypertensive treatment should include anACEIorARBtoimprovekidneyoutcomes.ThisappliestoallCKD patients with hypertension regardless of race or diabetes status. Moderate Recommendation Grade B 32) that treatment with an ACEI or ARB improves kidney outcomes for patients with CKD. This recommendation applies to CKD pa- tients with and without proteinuria, as studies using ACEIs or ARBs showed evidence of improved kidney outcomes in both groups. This recommendation is based primarily on kidney outcomes because there is less evidence favoring ACEI or ARB for cardiovas- cular outcomes in patients with CKD. Neither ACEIs nor ARBs im- proved cardiovascular outcomes for CKD patients compared with (IDNT)didshowimprovementinheartfailureoutcomeswithanARB compared with a CCB, but this trial was restricted to a population with diabetic nephropathy and proteinuria (question 3, evidence There are no RCTs in the evidence review that di- rectlycomparedACEItoARBforanycardiovascularoutcome.How- ever, both are renin-angiotensin system inhibitors and have been shown to have similar effects on kidney outcomes (question 3, evi- dence statements 31-32). Recommendation 8 is specifically directed at those with CKD and hypertension and addresses the potential benefit of specific drugs on kidney outcomes. 