Is the plasma aldosterone-to-renin ratio associated with blood pressure response to treatment in general practice?

Autor:	Käyser SC; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands., Schalk BWM; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands., de Grauw WJC; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands., Schermer TR; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.; Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands., Akkermans RP; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.; Radboud Institute for Health Sciences, IQ Healthcare., Lenders JWM; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.; Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Deinum J; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands., Biermans MCJ; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Family practice [Fam Pract] 2019 Mar 20; Vol. 36 (2), pp. 154-161.
DOI:	10.1093/fampra/cmy039
Abstrakt:	Background: Individualized antihypertensive treatment based on specific biomarkers such as renin may lead to more effective blood pressure control in patients with newly diagnosed essential hypertension. Recent studies suggested that the plasma aldosterone-to-renin ratio (ARR) may also be a candidate predictor for this purpose. Objective: To assess whether the ARR is associated with the blood pressure response to antihypertensive treatment in patients with newly diagnosed hypertension. Methods: In this prospective cohort study in primary care, we determined the ARR in patients with newly diagnosed hypertension prior to starting treatment. Treatment was categorized in five groups: no medication, use of angiotensin-converting-enzyme inhibitor or angiotensin receptor blocker, use of calcium channel blocker, use of diuretic, or use of beta blocker. We examined the relation between the ARR and blood pressure response within 1 year of treatment, taking into account the type of antihypertensive treatment and adjusting for gender, age, baseline blood pressure, and comorbidity. Results: Out of 304 patients, we used 947 measurements (727 no medication, 220 medication) for analysis. There was no association between the ARR and the response in blood pressure, and this applied to each treatment group. Target blood pressure, defined as systolic blood pressure <140 mmHg, was reached in 31% of patients. There was no association between the ARR and reaching target blood pressure (OR 1.002, 95% CI 0.983-1.022). Conclusion: The ARR is not associated with the response in blood pressure within 1 year of antihypertensive treatment in primary care. (© The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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