Common Hypertension Drugs Can Raise Blood Pressure in Certain Patients

(Science Daily News) — “Our findings suggest that physicians should use renin levels to predict the most appropriate first drug for treating with ,” says lead author Michael Alderman, M.D., professor of epidemiology & population health and of medicine at Einstein. “This would increase the likelihood of achieving blood pressure control and reduce the need for to take additional antihypertensive medications.”

The study involved 945 who were enrolled in a workplace antihypertensive treatment program in New York City from 1981 to 1998. All had a systolic blood pressure (SBP) of at least 140 mmHg. SBP, the top number in the blood pressure reading, represents the amount of force that blood exerts on the walls of blood vessels when the heart contracts. No were receiving treatment for high blood pressure before enrolling in the study.

The were given a single antihypertensive medication, either a diuretic or a calcium channel blocker (so-called “V” , which lower blood volume) or a beta blocker or an ACE inhibitor (“R” , which lower levels of renin, an enzyme secreted by the kidneys that plays a key role in maintaining blood pressure).

Plasma renin activity (PRA) and SBP were measured at enrollment, and SBP was measured again after one to three months of treatment. The renin level predicted those who were most likely to have a favorable response with either an R or a V drug. In addition, for both R and V , the renin test was able to identify those most likely to experience a “pressor response” — a clinically significant increase in SBP of 10 mmHg or more.


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