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1987•Archives of Internal MedicineRequires access

Influence of renin levels on the treatment of essential hypertension with thiazide diuretics

R. N. Wyndham

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Abstract

• Initial plasma renin activity (PRA) was measured in 213 patients with untreated hypertension before beginning thiazide (chlorothiazide and hydrochlorothiazide) therapy alone to test whether patients with low-renin hypertension exhibited a greater response to diuretic therapy. Diastolic blood pressure response to treatment in the low, mid-range, and high PRA groups did not differ significantly (Δ diastolic blood pressure, -13.6±1.6, -11.6±1.5, and -10.8±2.6 mm Hg, respectively). Moreover, eight subjects with the highest PRA values exhibited the same magnitude of decrease in diastolic blood pressure as did the low PRA group (15.0±4.2 vs 13.6 ±1.6, respectively). This study thus provides no evidence for increased sensitivity to diuretic therapy among patients with low-renin essential hypertension. (Arch Intern Med1987;147:1021-1025)

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What this paper is about

• Initial plasma renin activity (PRA) was measured in 213 patients with untreated hypertension before beginning thiazide (chlorothiazide and hydrochlorothiazide) therapy alone to test whether patients with low-renin hypertension exhibited a greater response to diuretic therapy. Diastolic blood pressure response to treatment in the low, mid-range, and high PRA groups did not differ significantly (Δ diastolic blood pressure, -13.6±1.6, -11.6±1.5, and -10.8±2.6 mm Hg, respectively). Moreover, eight subjects with the highest PRA values exhibited the same magnitude of decrease in diastolic blood pressure as did the low PRA group (15.0±4.2 vs 13.6 ±1.6, respectively). This study thus provides no evidence for increased sensitivity to diuretic therapy among patients with low-renin essential hypertension. (Arch Intern Med1987;147:1021-1025)

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Available abstract

• Initial plasma renin activity (PRA) was measured in 213 patients with untreated hypertension before beginning thiazide (chlorothiazide and hydrochlorothiazide) therapy alone to test whether patients with low-renin hypertension exhibited a greater response to diuretic therapy. Diastolic blood pressure response to treatment in the low, mid-range, and high PRA groups did not differ significantly (Δ diastolic blood pressure, -13.6±1.6, -11.6±1.5, and -10.8±2.6 mm Hg, respectively). Moreover, eight subjects with the highest PRA values exhibited the same magnitude of decrease in diastolic blood pressure as did the low PRA group (15.0±4.2 vs 13.6 ±1.6, respectively). This study thus provides no evidence for increased sensitivity to diuretic therapy among patients with low-renin essential hypertension. (Arch Intern Med1987;147:1021-1025)

Key concepts: Hydrochlorothiazide, Thiazide, Chlorothiazide, Plasma renin activity, Blood pressure, Diuretic, Medicine, Internal medicine

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