Document Detail


Plasma renin predicts success of antihypertensive drug withdrawal.
MedLine Citation:
PMID:  7986457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study examined the relationship of plasma renin activity (PRA) to the likelihood of maintaining blood pressure control after discontinuation of antihypertensive medication. Patients whose blood pressure was previously treated and controlled in the Hypertension Detection and Follow-up Program were enrolled in the Dietary Intervention Study of Hypertension. After stratification by obesity, patients were randomized to discontinue medication with no dietary intervention, sodium restriction, or weight reduction for the obese. Among 496 subjects in the Dietary Intervention Study of Hypertension, 75 were randomly selected for PRA measurement at 4 months after intervention, and all had their blood pressure under control at that time. Patients were followed up for 56 weeks after randomization. The endpoint was return to antihypertensive medication due to elevated diastolic blood pressure. Kaplan-Meier survival analysis showed that subjects with PRA < or = 53.3 ng/100 mL/h, the median level, had a lower cumulative success rate for remaining off antihypertensive drug than those with PRA above the median (P = .046). In Cox regression analysis controlling for 24-h urinary sodium level, baseline diastolic blood pressure, age, sex, race, obesity, and dietary intervention group, a unit decrease in log PRA was associated with a 2.78-fold increase in risk of returning to drug (P = .006); this inverse relationship was independent of dietary intervention and change in diastolic blood pressure in the first 4 months before PRA was measured. The data indicate that patients with low PRA are less likely to maintain blood pressure control without drugs than patients with high PRA.
Authors:
G Y Ho; M D Blaufox; S Wassertheil-Smoller; A Oberman; H Langford
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of hypertension     Volume:  7     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  1994 Aug 
Date Detail:
Created Date:  1995-01-12     Completed Date:  1995-01-12     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  679-84     Citation Subset:  IM    
Affiliation:
Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, New York 10461.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Analysis of Variance
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects
Diet, Reducing*
Diet, Sodium-Restricted*
Female
Follow-Up Studies
Humans
Hypertension / diet therapy,  drug therapy*
Male
Middle Aged
Potassium / administration & dosage
Regression Analysis
Renin / blood*
Risk Factors
Sex Factors
Sodium / urine
Grant Support
ID/Acronym/Agency:
5RO3HL46559/HL/NHLBI NIH HHS; R01HL24369/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 7440-09-7/Potassium; 7440-23-5/Sodium; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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