Why the study?
Does baseline plasma renin activity predict the diastolic blood pressure response to thiazide diuretics in patients with untreated essential hypertension?
Does baseline plasma renin activity predict the diastolic blood pressure response to thiazide diuretics in patients with untreated essential hypertension?
Baseline plasma renin activity does not predict the magnitude of blood pressure reduction in response to thiazide diuretics in patients with essential hypertension.
Baseline PRA should not guide thiazide selection in essential hypertension; observational data leave its role in other settings unresolved.
Initial plasma renin activity (PRA) was measured in 213 patients with untreated hypertension before beginning thiazide (chlorothiazide and hydrochlorothiazide) therapy alone to test whether patients with low-renin hypertension exhibited a greater response to diuretic therapy. Diastolic blood pressure response to treatment in the low, mid-range, and high PRA groups did not differ significantly (delta diastolic blood pressure, -13.6 +/- 1.6, -11.6 +/- 1.5, and -10.8 +/- 2.6 mm Hg, respectively). Moreover, eight subjects with the highest PRA values exhibited the same magnitude of decrease in diastolic blood pressure as did the low PRA group (15.0 +/- 4.2 vs 13.6 +/- 1.6, respectively). This study thus provides no evidence for increased sensitivity to diuretic therapy among patients with low-renin essential hypertension.
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Roger Wyndham (1987) studied this question.
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