Authors’ reply to Ladapo and Ogedegbe

We would like to thanks Ladapo and Ogedegbe for their comments on our paper.1 2 They rightly point out data suggesting that people from different ethnic groups respond differently to blood pressure lowering drugs, as shown for African-Americans compared with Americans of other backgrounds. A substantial number of data on this important question are available from individual trials, but to our knowledge no study suggests that ethnic differences might be further modified by kidney function.

The Blood Pressure Lowering Treatment Trialists’ Collaboration is a prospectively planned series of meta-analyses, with prespecified hypotheses, outcomes, and analysis plans. The protocol has prespecified subgroup analyses with tests of interaction performed to assess the association of any treatment differences with several patient characteristics—age, sex, diabetes status, baseline blood pressure, and baseline kidney function. Although ethnicity was not included in the original prespecified secondary analyses, we will explore opportunities to undertake these analyses with members of the collaboration across all levels of kidney function.