REN and chronic kidney disease: This connects to the common idea in biomedical research that Black people are predisposed to low concentrations of renin, the enzyme that converts angiotensin to angiotensin I in the RAAS, and therefore decreased PRA.14 This is conceptualized within the JNC 8 guideline: ACE inhibitors (which work in the RAAS) are not recommended as an initial therapy for Black hypertensive patients, until they have CKD, and their renin levels are presumably elevated to a level higher than “typical” for Black patients.