(CardiologyToday.com) — Despite the prescription of antihypertensive therapy and the widespread availability and promotion of practice guidelines, an estimated 17 million people in the United States suffer from uncontrolled BP.
Current management strategies for hypertension are based on practice guidelines that recommend clinicians utilize a stepwise approach when initiating antihypertensive therapy. This practice strategy was in part influenced by the landmark BP treatment study, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). However, ALLHAT, although internationally acclaimed, resulted in only 66% of patients treated with antihypertensive therapy achieving BP control (<140 mm Hg systolic and <90 mm Hg diastolic), with 62.5% requiring combination of two or three antihypertensives.
Global underachievement in reaching BP targets, when considered in the context of the ALLHAT results, have ignited an interrogation of guideline-recommended hypertension treatment strategies, specifically the “one-size-fits-all” stepwise approach. In fact, it has been reported that up to 73% of hypertensive patients treated with antihypertensives can be controlled with monotherapy if a patient’s “best” antihypertensive is selected using independent trials of diuretics, calcium channel blockers, beta-blockers and ACE inhibitors.
Based on these findings, clinicians and scientists continue to pursue methods to individualize, or tailor, antihypertensive therapies. One promising strategy includes the measurement of plasma renin activity (PRA) and subsequent identification and classification of renin activity, also referred to as “renin profiling.”
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I have been reading articles for over a year about renin profiling in treating resistant hypertension. Is there a doctor or cardiologist anywhere in the U.S. who uses this diagnostic tool for his patients? By the time it becomes widespread, it will be too late for some of us.
I have read that drinking all natural coca tea is a healthy remedy for hyperactivity. It three any studies being done here in the Uniter States? Since importing the leaves here is illegal unless they have been decocaineized. Which by the way reduces the effect of the tea.