June 1987

Influence of Renin Levels on the Treatment of Essential Hypertension With Thiazide Diuretics

Author Affiliations

From the Division of Nephrology, Department of Medicine, The Johns Hopkins University and Hospital, and the O'Neill Research Laboratory of the Good Samaritan Hospital, Baltimore. Dr Wyndham is currently at the Renal Unit, Repatriation General Hospital, Concord, Australia.

Arch Intern Med. 1987;147(6):1021-1025. doi:10.1001/archinte.1987.00370060017003

• 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 Med 1987;147:1021-1025)