Is low-renin hypertension an overdiagnosed syndrome?

The controversy surrounding low-renin hypertension ranges from the concept that it carries a favorable prognosis to the therory that it a form of nephrosclerosis. At least a part of the debate may result from the use of different methods of classifying patients with this condition. The study presented here clearly shows that age and sex have an important influence on plasma renin activity. Women had lower values than age-matched men, and studies in normal volunteers showed that plasma renin activity decreases with age. Other factors also affect renin profiling. Diabetes is associated with renin suppression, and blacks have lower values of plasma renin activity than whites. In addition, use of anti-inflammatory drugs such as aspirin significantly lowers renin levels. Since some of these variables have not been considered in published studies to date, it would seem that the true incidence of low-renin hypertension among hypertensives is lower than the accepted figure of 25%.