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Pretreatment levels of plasma renin activity predict ambulatory blood pressure response to valsartan in essential hypertension

Journal of Human Hypertension volume 23, pages 683–686 (2009)Cite this article

Angiotensin receptor blockers (ARBs) are gaining a great market in most countries. The major current hypertension guidelines (1–3) recommend ARBs as first-line drugs for the treatment of hypertension; however, it is assumed that patients with lower renin hypertension respond less to monotherapy with a blocker of the renin–angiotensin system (RAS), such as an ARB, than those with higher renin hypertension.

Monotherapy with an RAS blocker may not be suitable for uncomplicated patients with low-renin hypertension, who are free from congestive heart failure, chronic kidney disease or diabetes mellitus. A growing body of evidence has shown that the effectiveness of antihypertensive medications is derived primarily from the blood pressure-lowering effect itself rather than the characteristic actions of various classes of antihypertensive drugs.1, 2, 3 To date, several investigators have studied the association of pretreatment plasma renin activity (PRA) levels with ambulatory blood pressure (ABP) responses to ARBs in essential hypertension.4, 5, 6 Recently, we showed that ABP reductions by telmisartan were significantly smaller in hypertensive patients with lower PRA levels than in those with higher PRA levels.4 However, it is uncertain whether the same is true of all ARBs. Among ARBs, valsartan has been suggested to be effective in lowering the blood pressure in both Whites and Blacks,7 although Blacks often show low-renin status. Thus, we conducted this study to investigate whether pretreatment PRA levels predicted an ABP response to valsartan in newly diagnosed patients with essential hypertension.

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Authors and Affiliations

  1. Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan

    J Minami, E Ohno, S Furukata, T Ishimitsu & H Matsuoka

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  1. J Minami
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  2. E Ohno
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  3. S Furukata
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  4. T Ishimitsu
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  5. H Matsuoka
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Minami, J., Ohno, E., Furukata, S. et al. Pretreatment levels of plasma renin activity predict ambulatory blood pressure response to valsartan in essential hypertension. J Hum Hypertens 23, 683–686 (2009). https://doi.org/10.1038/jhh.2009.31

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