Renin-guided antihypertensive management significantly reduced systolic blood pressure from 152.17 to 138.0 mmHg in uncontrolled patients and from 133.83 to 123.87 mmHg in controlled patients (p<0.05).
Cohort (n=896)
No
Does renin-guided antihypertensive management improve blood pressure control and reduce the number of medications in patients with primary hypertension?
Renin-guided antihypertensive therapy significantly improves blood pressure control and reduces the number of required medications in patients with primary hypertension.
p-value: p=< 0.05
BACKGROUND: Most guidelines for hypertension overlook the underlying pathophysiologic basis in deciding antihypertensives. Based on renin levels, hypertension may be classified as high-renin hypertension (HRH), low-renin hypertension (LRH), and normal-renin hypertension (NRH). The study examined the renin levels in a hypertensive population and assessed the effect of renin-guided antihypertensive management on blood pressure (BP) control. MATERIALS AND METHODS: This study was a single-center prospective cohort study. Subjects with primary hypertension (aged 20-60 years) on antihypertensives were included in the study. Initial BP was recorded and subsequently, all antihypertensives were discontinued. After 2 weeks, second BP was recorded and plasma renin assay (PRA) sample was collected. All patients were restarted on the previous antihypertensives and further modification of medication was performed based on their PRA. Anti V drugs, such as diuretics and calcium channel blockers (CCBs) were used in LRH while beta-blockers and antirenin drugs (Anti R drugs) were used in HRH. RESULTS: The study included 918 patients with hypertension and 896 cases were finally analyzed. Of these patients, 287 (32.03%) had LRH (2.64 ng/mL/hr), while 197 (21.99%) had NRH (0.51-2.64 ng/mL/hr). Renin-guided management caused significant BP reduction. In controlled BP group, the systolic BP (SBP)/diastolic BP (DBP) before and after modification were 133.83 ± 3.36/84.77 ± 3.12 and 123.87 ± 10.59/84.05 ± 1.84, respectively (p-value < 0.05). In uncontrolled BP group, the corresponding SBP/DBP were 152.17 ± 2.95/90.36 ± 5.02 and 138 ± 1.23/87.78 ± 0.84, respectively (p-value < 0.05). The number of hypertensives used in patients also reduced with reduction in patients on two, three, or four drugs. CONCLUSIONS: Renin-guided therapy is useful for improving BP control in both controlled and uncontrolled hypertensive patients and in reducing the number of antihypertensive drugs.
Murty et al. (2022) conducted a cohort in Primary hypertension (n=896). Renin-guided antihypertensive management vs. Previous antihypertensive therapy (before modification) was evaluated on Blood pressure (BP) reduction (p=< 0.05). Renin-guided antihypertensive management significantly reduced systolic blood pressure from 152.17 to 138.0 mmHg in uncontrolled patients and from 133.83 to 123.87 mmHg in controlled patients (p<0.05).