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Logo of nihpaAbout Author manuscriptsSubmit a manuscriptHHS Public Access; Author Manuscript; Accepted for publication in peer reviewed journal;
Hypertension. Author manuscript; available in PMC 2010 November 17.
Published in final edited form as:
PMCID: PMC2983107

LETTER TO THE EDITOR: Uncritical acceptance of COOPERATE Trial results

To The Editor

We have just read the published editorial in the current issue of Hypertension by Dr. Kaplan about “Recent Clinical Trials: The Good, The Bad and The Misleading”1 with great interest. We very much agree with his comments and in particular, share his concerns with respect to an uncritical acceptance of the results of “the bad trial” (COOPERATE), given the many red flags that were apparently overlooked. Therefore, we were surprised to see ourselves cited (Ref. #15) among the expert nephrologists who have accepted the results of the COOPERATE trial2. Our cited review had in fact, questioned the BP-independent specificity of renin angiotensin system (RAS) blockade in preventing the progression of renal disease3. The citation is also particularly ironic because one of us had questioned the veracity of the COOPERATE ABPM data4 ~18 months before Dr. Kunz’ letter of concern to the Lancet, as also noted recently in another editorial comment regarding the ONTARGET Trial5.


1. Kaplan NM. Recent clinical trials: The good, the bad, and the misleading. Hypertens. 2008;52:608–609. [PubMed]
2. Nakao N, Yoshimura A, Morita H, Takada M, Kayano T, Ideura T. Combination treatment of angiotensin II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE): a randomized controlled trial. Lancet. 2003;1:117–124. [PubMed]
3. Griffin KA, Bidani AK. Progression of renal disease renoprotective specificity of renin-angiotensin system blockade. Clin J Am Soc Nephrol. 2006;1:1054–1065. [PubMed]
4. Bidani A. Controversy about COOPERATE ABPM Trial Data. Am J Nephrol. 2006;26:629–632. [PubMed]
5. Sarafidis PA, Bakris GL. Renin-angiotensin blockade and kidney disease. Lancet. 2008;372:511–512. [PubMed]