Abstract 404: The Use of Renin and Aldosterone Profiling in the Treatment of Complex Hypertension
Uncontrolled hypertension (HTN) remains highly prevalent and contributes to the risk for increased CVD and stroke. The purpose of this study is to determine if renin/aldosterone profiling in patients new to the complex HTN clinic would aid in identification of certain subsets of HTN and lead to improved BP control.
Methods: We conducted a retrospective study of all new patients seen at the Penn HTN clinic by a single HTN specialist between 2005-2010. We examined all adult patients that were screened with plasma renin (ng/ml) and serum aldosterone (ng/dl) levels. Patients with known causes of secondary HTN such as pheochromocytoma were excluded. All data was reviewed from the first visit and for all subsequent visits for the first year. The patients were classified as follows: normal, salt sensitive (renin < 1, aldo <15), hyperaldosteronism (renin < 1, aldo ≥ 15) and high renin (renin ≥ 10). Medications were then tailored to the individual profile.
Results: We identified 158 patients with a mean age of 52.9 ± 1.25 years, 47% (74 of 158) males; 53% (84 of 158) females; 75% (117 of 158) were white; 21% (33 of 158) black and 4 % (6 of 158) other. The mean SBP/DBP at baseline for the entire cohort was 149/87 ± 1.85/1.17 mmHg and was decreased by a mean of 20.3/8.6 ± 1.88/1.2 at 1 year (p=0.000). There was no change in the overall number of medications at baseline and at one year despite improved BP control ( p = 0.770).
Conclusion: Renin/aldosterone profiling in subjects with severe HTN helps the physician tailor therapy resulting in improved BP control without an overall increase in the number of medications needed. Most patients did require at least 3 meds to achieve good BP control.
- © 2012 by American Heart Association, Inc.