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Published on: May 17, 2024
Pressor responses to antihypertensive drug types
Michael H Alderman1, Hillel W Cohen, Jean E Sealey
1Department of Epidemiology, Albert Einstein College of Medicine, Bronx, New York, USA. michael.alderman@einstein.yu.edu
American Journal of Hypertension
|August 21, 2010
Summary
Pressor responses to antihypertensive drugs are common, particularly with antirenin medications in patients with low plasma renin activity. Careful drug selection is crucial for effective blood pressure management.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Hypertension Research
Background:
- Pressor responses to antihypertensive drugs are not well-addressed in current treatment guidelines.
- These responses have been observed in various clinical scenarios, necessitating further investigation.
- This study examines pressor responses during antihypertensive monotherapy initiation.
Purpose of the Study:
- To determine the incidence of pressor responses to four types of antihypertensive monotherapy.
- To investigate the influence of plasma renin activity (PRA) status on these pressor responses.
- To compare pressor responses between natriuretic (V) and antirenin (R) drug classes.
Main Methods:
- Evaluated systolic blood pressure (SBP) response in 945 treatment-naive participants.
- Administered either diuretic/calcium-channel blockers (V drugs) or beta-blocker/ACE inhibitors (R drugs).
- Categorized PRA into low, middle, and high tertiles; defined pressor response as SBP rise ≥10 mm Hg.
Main Results:
- Pressor responses were more frequent with R drugs (11%) than V drugs (5%) (P=0.001).
- Low and middle PRA tertiles showed greater pressor frequencies with R drugs compared to V drugs.
- Higher SBP (≥160 mm Hg) occurred more with R drugs, especially in the lowest renin tertile (35% vs. 13%).
Conclusions:
- Pressor responses to antihypertensive monotherapy are a significant clinical concern.
- Patients with lower renin levels are particularly susceptible to pressor responses with beta-blockers or ACE inhibitors.
- These findings highlight the importance of considering PRA status in antihypertensive drug selection.
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