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Low-renin primary (essential) hypertension

Norman M Kaplan, MD
Section Editor
George L Bakris, MD
Deputy Editor
John P Forman, MD, MSc


Renin-sodium profiling in patients with primary hypertension (formerly called "essential" hypertension) reveals that the plasma renin activity (PRA) is increased in 15 percent, normal in 60 percent, and reduced in approximately 25 percent [1]. Low renin levels are found more frequently in blacks and in the elderly [2].

Although it is likely that patients with low-renin primary hypertension (LRPH) represent part of a continuum of hypertensives, this subgroup may have some relatively unique characteristics:

The elevation in blood pressure is more likely to be salt sensitive [3]

The response to nonpharmacologic therapy, particularly weight reduction, may be less pronounced [4]

The antihypertensive response may be greatest with a diuretic or calcium channel blocker [1,3,5]

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Literature review current through: Oct 2017. | This topic last updated: Oct 05, 2015.
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