Renin-Guided Therapeutics in the Management of Untreated, Uncontrolled, or Complicated Hypertension

Hypertension affects \~25% of adults. The prevalence of hypertension and related complications is greater among the elderly, obese, and ethnic minorities. Unfortunately, hypertension control rates remain in the 25% range and are often significantly lower for the high-risk groups noted.1 Since the high-risk groups are growing more rapidly than the general population, the prevalence of hypertension and associated morbidity and mortality will probably increase sharply in the years ahead unless successful strategies are implemented for dramatically improving blood pressure control. Direct measurements of plasma renin reflect the relative balance between volume (V) and vasoconstrictor (renin \[R\]) factors underlying the elevated blood pressure in patients with essential hypertension.2 While many antihypertensive medications have effects on both the volume (V) and vasoconstrictor (renin \[R\]) components of elevated blood pressure, one or the other usually predominates