Renin-guided therapy helpful for reducing BP and number of drugs in patients of hypertension

This study was a single-centre 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, a second BP was recorded and a 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 had LRH had HRH while 197 had NRH.
• Renin-guided management caused significant BP reduction.
• In the 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
• In the 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
• The number of hypertensives used in patients also reduced with the reduction in patients on two, three, or four drugs.

Renin-guided therapy is useful for improving BP control in both controlled and uncontrolled hypertensive patients in reducing the number of antihypertensive drugs.

Reference:

MSN Murty et al. Plasma Renin-guided Therapy in Patients of Primary Hypertension on Antihypertensives: A Prospective Cohort Study. DOI: 10.5005/japi-11001-0061