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Renin and prorenin as biomarkers in hypertension

A H Jan Danser1

  • 1Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands. a.danser@erasmusmc.nl

Current Opinion in Nephrology and Hypertension
|July 24, 2012
PubMed

Insights

High plasma renin levels, not prorenin, indicate increased cardiovascular risk, especially in hypertensive patients. However, measuring renin offers limited value for individual patient treatment decisions or predicting cardiovascular events.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Pharmacology

Background:

  • Plasma renin and prorenin levels are investigated for their role in hypertension and cardiovascular disease.
  • Understanding the prognostic value of these markers is crucial for patient management.

Purpose of the Study:

  • To review evidence on using plasma renin and prorenin levels to guide hypertension therapy.
  • To assess their role as independent risk factors for future cardiovascular events.

Main Methods:

  • Retrospective analyses of patient populations from clinical trials with available baseline renin measurements.
  • Evaluation of the association between renin/prorenin levels and cardiovascular outcomes.

Main Results:

  • High renin levels, but not prorenin, correlate with future cardiovascular disease and mortality, particularly in patients with kidney dysfunction and/or hypertension.
  • This association persists despite the use of renin-angiotensin system (RAS) blockers.
  • High renin levels suggest RAS inhibitors may be a preferred first-line antihypertensive, though individual responses vary.

Conclusions:

  • Measuring baseline renin has limited value for predicting individual cardiovascular events.
  • Its utility in guiding drug selection for hypertension in individual patients is also modest.
Abstract

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