title: [Plasma Renin Activity and Potential of Indapamide Retard to Improve Control of Hypertension].
abstract: OBJECTIVE
  to study plasma renin activity (PRA) as a predictor of antihypertensive response to addition of diuretic to combination of angiotensin- converting enzyme inhibitor (ACEI) and calcium antagonist (CA).
  
  
  METHODS
  The study included 72 patients (39% men, mean age 62.0 ± 8.3 years) with uncontrolled despite use of ACEI and CA arterial hypertension (AH) without overt associated clinical conditions (AH criteria of national guidelines, 2010). After 4 weeks of therapy with ACE inhibitor (quadropril 6 mg/day) and CA (felodipine 5 mg/day) in all patients who did not reach target level of blood pressure (BP) (clinical BP≥140/90 mm Hg, daytime BP according to ambulatory BP monitoring [ABPM] >135/85 mm Hg) indapamide retard (1.5 mg/day) was added to combination therapy for 6 months. Examination included measurement of baseline and on treatment PRA and repetitive ABPM.
  
  
  RESULTS
  More pronounced antihypertensive response was observed in the group of patients with volume dependent AH. Baseline BP was 156.6 ± 14.1/86.7 ± 1.5 and 151.9 ± 17.1/78.0 ± 7.8 mm Hg, on treatment level of clinical BP - 126.2 ± 10.6/72.5 ± 11.6 and 132.2 ± 9.1/71.9 ± 7.2 mm Hg (p<0.05) in patients with volume dependent and renin dependent AH, respectively. Target clinical BP was achieved in 95 and 80% of patients, respectively (χ2= 10.3; p<0.05). According to ABPM both daytime and nighttime on treatment BP was lower in the group of patients with volume dependent AH (130.0 ± 11.0/74.1 ± 9.9 vs. 136.5 ± 7.3/78.8 ± 8.2 mm Hg, p<0.05; and 127.9 ± 15.8/71 ± 13.5 vs. 132.6 ± 13.0/74.5 ± 10.2 mm Hg, p<0.05).
  
  
  CONCLUSIONS
  PRA is an independent predictor of antihypertensive response to addition of a diuretic to combination therapy with ACEI and CA.
authors.forename: Zh D
authors.initials: ZhD
authors.lastname: Kobalava
authors.forename: Iu V
authors.initials: IuV
authors.lastname: Kotovskaia
authors.forename: O A
authors.initials: OA
authors.lastname: Kravtsova
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy; D007190:Indapamide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D012083:Renin; D007190:Indapamide