Renin-angiotensin profile and comparative effectiveness of first-line medications in monotherapy of essential arterial hypertension
The study investigated the rational antihypertensive therapy in 966 patients with essential arterial hypertension (AH) and various renin-angiotensin blood profiles. Mean age was 51,4±10,2 years, mean systolic blood pressure (SBP) - 193,3±7,4 mm Hg, and mean diastolic BP (DBP) - 113,3± 4,8 mm Hg. Plasma renin activity (PRA; normal levels 1,0-3,0 ng/ml/h) and plasma aldosterone concentration (PAC; normal levels 5-23 ng/dl) were measured by radio-immune methods. The normal ratio of PAC (ng/dl) to PRA (ng/ml/h) is 5-23. It was demonstrated that in patients with PRA<0,22 ng/ml/h, the main monotherapy medications were angiotensin II receptor antagonists (ARA) and angiotensin-converting enzyme inhibitors (ACEI). In patients with PRA 0,22-1,0 ng/ml/h and PAC: PRA ratio 5-23, the main monotherapy medications were calcium antagonists (CA) and hydrochlorothiazide; in patients with PAC: PRA ratio >23 - ACEI and ARA; in patients with PRA 1,0-3,0 mg/ml/h and normoaldosteronism - CA; in patients with PRA >3,0 ng/ml/h and PAC: PRA ratio <5 - beta-adrenoblockers.