Renin and Hypertension

To the Editor.— The article by Laragh and associates inTHE JOURNAL(241:151, 1979) concerning renin profiling for the diagnosis and treatment of hypertensive patients puts the renin-angiotensin system in a unique position in regard to other humoral substances. There is question whether it deserves this lofty position over other vasoactive materials. When one attempts to use the authors' plan for predicting successful therapy, the many failures emphasize the incompleteness of our knowledge at this time.¹ One section of the article that is misleading concerns the effect of renin on morbidity in the hypertensive patient. In the article, the authors indicate that given two hypertensive patients with equal blood pressures, one with an elevated plasma renin activity and one with low activity, the physician would have a different attitude of the pace and severity of the two disorders and, therefore, about both direction and urgency of workup and treatment