11.13 Utility of Determination of Plasma Renin Activity in Choosing the Antihypertensive Treatment
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High Blood Press Cardiovasc Prev 2008; 15 (3): 171-215 1120-9879/08/0003-0171/$48.00/0 © 2008 Adis Data Information BV. All rights reserved.
Therapy, Pharmacoeconomics and Pharmacovigilance 11.13 Utility of Determination of Plasma Renin Activity in Choosing the Antihypertensive Treatment G. Leotta (1), F. Rabbia (1), P. Mulatero (1), E. Testa (1), E. Saglio (1), F. Tosello (1), A. Viola (1), F. Veglio (1) ` di Torino, Centro Ipertensione Arteriosa, Torino, Italy (1)Universita Introduction. According to the Laragh hypothesis, antihypertensive treatment should be chosen upon plasma renin activity (PRA) levels (an antisodium-volume drug for patients with PRA 0.65 ng/mL/h), thus providing a high monotherapy success rate (60-80%). Aim. To determine whether response rates to antihypertensive treatment and reductions in blood pressure values were higher among hypertensive patients treated with drugs appropriate to their PRA level than in the other patients. Methods. We reviewed computer-stored data of 170 Caucasian hypertensive patients (age 18-72 years, 109 males and 61 females) referred to a hypertension clinic in Turin (Italy). All patients were untreated before the admission to the clinic and underwent a baseline visit, during which the physicians measured systolic and diastolic blood pressure (SBP and DBP), collected samples for PRA in the standing position and prescribed an antihypertensive monotherapy, without knowing the result of PRA determination. After a month of treatment a follow up visit was performed, to evaluate the response to the treatment. We classified the patients in two groups according to the appropriateness or less of prescribed drug to PRA level. We compared response rates to the treatment and reductions in BP values between the groups. Moreover, we performed a regression analysis, between BP reduction (dependent variable) and appropriateness or less of prescribed drugs (independent variable). Results. Treatment with a drug appropriate to PRA level slightly increased the number of patients reaching target BP (BP
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