Document Detail


Plasma renin activity predicts blood pressure responses to beta-blocker and thiazide diuretic as monotherapy and add-on therapy for hypertension.
MedLine Citation:
PMID:  20725057     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Age and race categories or renin profiling have been recommended to predict blood pressure responses to monotherapy with a beta-blocker or thiazide diuretic. Whether these or other characteristics predict blood pressure responses when the drugs are administered as add-on therapy is uncertain.
METHODS: We evaluated predictors of blood pressure response in 363 men and women < or =65 years of age with primary hypertension (152 blacks, 211 whites), 86 of whom (24%) were untreated and 277 of whom (76%) were withdrawn from previous antihypertensive drugs before randomization to either atenolol followed by addition of hydrochlorothiazide (N = 180) or hydrochlorothiazide followed by addition of atenolol (N = 183). Responses were determined by home blood pressure averages before and after each drug administration. Race, age, plasma renin activity, and other characteristics including pretreatment blood pressure levels were incorporated into linear regression models to quantify their contributions to prediction of blood pressure responses.
RESULTS: Plasma renin activity and pretreatment blood pressure level consistently contributed to prediction of systolic and diastolic responses to each drug administered as mono- and as add-on therapy. Higher plasma renin activity was consistently associated with greater blood pressure responses to atenolol and lesser responses to hydrochlorothiazide. The predictive effects of plasma renin activity were statistically independent of race, age, and other characteristics.
CONCLUSIONS: Plasma renin activity and pretreatment blood pressure level predict blood pressure responses to atenolol and hydrochlorothiazide administered as mono- and as add-on therapy in men and women < or =65 years of age.
Authors:
Stephen T Turner; Gary L Schwartz; Arlene B Chapman; Amber L Beitelshees; John G Gums; Rhonda M Cooper-DeHoff; Eric Boerwinkle; Julie A Johnson; Kent R Bailey
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2010-08-19
Journal Detail:
Title:  American journal of hypertension     Volume:  23     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2010-12-07     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1014-22     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Alcohol Drinking / adverse effects,  epidemiology
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects*
Body Mass Index
Drug Therapy, Combination
Female
Humans
Hypertension / blood,  drug therapy*
Male
Middle Aged
Randomized Controlled Trials as Topic
Renin / blood*
Sodium Chloride Symporter Inhibitors / therapeutic use*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K23 HL091120/HL/NHLBI NIH HHS; K23-HL091120/HL/NHLBI NIH HHS; M01 RR000585/RR/NCRR NIH HHS; M01 RR000585-332081/RR/NCRR NIH HHS; M01 RR000585-342081/RR/NCRR NIH HHS; M01-RR 00585/RR/NCRR NIH HHS; M01‑RR 00039/RR/NCRR NIH HHS; U01 GM074492/GM/NIGMS NIH HHS; U01 GM074492-07/GM/NIGMS NIH HHS; U01-GM074492/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Antihypertensive Agents; 0/Sodium Chloride Symporter Inhibitors; EC 3.4.23.15/Renin
Comments/Corrections
Comment In:
Am J Hypertens. 2010 Sep;23(9):926-8   [PMID:  20733564 ]
Am J Hypertens. 2010 Sep;23(9):929-30   [PMID:  20733565 ]

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