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Related Experiment Video

Updated: Apr 20, 2026

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

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Published on: May 26, 2022

Plasma renin testing to guide antihypertensive therapy.

Anthony J Viera¹, Curt D Furberg

¹Hypertension Research Program, University of North Carolina School of Medicine, Chapel Hill, NC, USA, anthony_viera@med.unc.edu.

Current Hypertension Reports

|November 30, 2014

Summary

Plasma renin activity (PRA)-guided therapy shows potential for personalized hypertension treatment. However, more research is needed to confirm its broad effectiveness compared to standard care.

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Area of Science:

Cardiovascular Medicine
Pharmacology
Hypertension Management

Background:

Plasma renin activity (PRA) is a biomarker used to guide antihypertensive medication selection based on patient pathophysiology.
Current evidence comparing PRA-guided therapy to usual care is limited, necessitating further investigation.

Purpose of the Study:

To evaluate the efficacy of PRA-guided therapy in hypertension management.
To compare PRA-guided strategies with usual care and fixed-dose therapies.

Main Methods:

Review of existing trials and modeling studies examining PRA-guided therapy.
Analysis of patient responses to different antihypertensive medications based on PRA levels.
Comparison of PRA-guided strategies with standard care and fixed-dose regimens.

Main Results:

One trial indicated PRA predicts response to beta-blockers and thiazide diuretics.
Another trial showed PRA-guided therapy superior to specialist care for add-on/subtraction therapy.
The ValVET study found no superiority of PRA-guided therapy over fixed-dose treatment.
Modeling suggests potential cost-effectiveness in specific patient groups.

Conclusions:

PRA-guided therapy shows promise for personalized hypertension treatment, with some evidence of efficacy in specific scenarios.
Further large-scale, randomized controlled trials are required to definitively establish the benefits and broad applicability of PRA-guided management.