title: Efficacy of antihypertensive treatment based on plasma renin activity: An open label observational study.
abstract: BACKGROUND
  We investigated the extent of blood pressure (BP) reduction and control (<140/90 mmHg) in patients treated with appropriate or inappropriate drugs according to their plasma renin activity (PRA) level (natriuretic drugs and renin-angiotensin system blockers for low-renin and high-renin hypertension, respectively).
  
  
  METHODS
  One hundred and seventy Caucasian untreated hypertensive patients (61 females), aged 18-70 years, participated to the study. Patients with secondary hypertension, diabetes or established cardiovascular or renal disease were excluded. The physician prescribed an antihypertensive monotherapy chosen among all drug classes, unaware of patient's PRA levels. We compared effect of an inappropriate or appropriate drug, evaluating BP values after a month of treatment.
  
  
  RESULTS
  Rate of BP control was not significantly higher in patients treated with an appropriate drug than the others (38% vs 29%, p=0.24). However, in a regression analysis, final diastolic BP (DBP) was lower in subjects treated with an appropriate drug (beta=-2.84, p=0.03).
  
  
  CONCLUSIONS
  The present study does not clearly support the use of PRA in a general population of hypertensive patients to optimize BP control. However, the greater efficacy of a drug appropriate to PRA in reducing DBP may be clinically helpful in young hypertensive patients. Future studies are warranted to evaluate if PRA determination enhances the therapeutic success in patients with predominantly high values of DBP.
authors.affiliation: Hypertension Unit, Department of Medicine and Experimental Oncology, University of Turin, Torino, Italy.
authors.forename: Giannina
authors.initials: G
authors.lastname: Leotta
authors.forename: Franco
authors.initials: F
authors.lastname: Rabbia
authors.forename: Elisa
authors.initials: E
authors.lastname: Testa
authors.forename: Silvia
authors.initials: S
authors.lastname: Totaro
authors.forename: Sara
authors.initials: S
authors.lastname: Abram
authors.forename: Alberto
authors.initials: A
authors.lastname: Milan
authors.forename: Paolo
authors.initials: P
authors.lastname: Mulatero
authors.forename: Franco
authors.initials: F
authors.lastname: Veglio
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood*; D012084:Renin-Angiotensin System / Q000187:drug effects
chemical_list: D000959:Antihypertensive Agents; D012083:Renin