A ‘new’ strategy for improving hypertension management

(CardiologyToday.com) — Despite the prescription of antihypertensive therapy and the widespread availability and promotion of practice guidelines, an estimated 17 million people in the United States suffer from uncontrolled BP.

Current management strategies for hypertension are based on practice guidelines that recommend clinicians utilize a stepwise approach when initiating antihypertensive therapy. This practice strategy was in part influenced by the landmark BP treatment study, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). However, ALLHAT, although internationally acclaimed, resulted in only 66% of patients treated with antihypertensive therapy achieving BP control (<140 mm Hg systolic and <90 mm Hg diastolic), with 62.5% requiring combination of two or three antihypertensives.

Global underachievement in reaching BP targets, when considered in the context of the ALLHAT results, have ignited an interrogation of guideline-recommended hypertension treatment strategies, specifically the “one-size-fits-all” stepwise approach. In fact, it has been reported that up to 73% of hypertensive patients treated with antihypertensives can be controlled with monotherapy if a patient’s “best” antihypertensive is selected using independent trials of diuretics, calcium channel blockers, beta-blockers and ACE inhibitors.

Based on these findings, clinicians and scientists continue to pursue methods to individualize, or tailor, antihypertensive therapies. One promising strategy includes the measurement of plasma renin activity (PRA) and subsequent identification and classification of renin activity, also referred to as “renin profiling.”


1 Star2 Stars3 Stars4 Stars5 Stars (2 votes, average: 3.00 out of 5)
Loading ... Loading ...