Using plasma renin (PRA) testing to design follow-up drug treatment strategies in hypertensive patients already taking antirenin system drugs.

摘要

A review of clinical trials of aliskiren published by Stanton et al. in this issue reveals that almost half of all hypertensive patients given the direct renin inhibitor, aliskiren, or an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB) fail to have their systolic BP (SBP) reduced by at least 10mmHg or their SBP controlled to <140mmHg (see their Figures 1 and 2). We previously explored the reasons for these poor responses. Stanton et al.l now accept our view that patients with low baseline plasma renin activity (PRA) have no renin to block and are more likely to respond to natriu-retic than to antirenin system drug types.