High blood pressure, also called hypertension, is a common health issue in the U.S., affecting nearly half of all adults. Many people don’t even realize they have it because it often has no symptoms. Hypertension happens when the force of blood pushing against artery walls is too high, which can lead to serious health problems like heart disease and stroke.
A new study from Yeshiva University has revealed a surprising finding—some widely used medications for high blood pressure can actually increase blood pressure in certain patients instead of lowering it.
The researchers suggest that doctors could avoid this problem by using a simple blood test to measure levels of an enzyme called renin. This test is becoming more available and could help doctors choose the best medication for each patient.
The study examined 945 patients who were part of a workplace treatment program for high blood pressure in New York City between 1981 and 1998. These patients all had a systolic blood pressure (the top number in a reading) of at least 140 mmHg.
Systolic pressure measures how much force the blood exerts on artery walls when the heart beats. None of the patients had taken any medication for high blood pressure before joining the study.
The researchers divided the patients into two groups based on the type of medication they received. Some took drugs that reduce blood volume, such as diuretics or calcium channel blockers (called “V” drugs). Others took beta blockers or ACE inhibitors (called “R” drugs), which lower renin levels. Renin is an enzyme released by the kidneys that plays an important role in controlling blood pressure.
Before starting treatment, the researchers measured each patient’s renin level and blood pressure. Then, after one to three months of treatment, they checked the patients’ blood pressure again. The results showed that a person’s renin level could predict how well they would respond to each type of drug.
For some patients, the wrong medication choice led to a “pressor response,” meaning their blood pressure actually increased by 10 mmHg or more. About 7.7% of all patients experienced this effect, but the highest risk was among those with low renin levels who were given beta blockers or ACE inhibitors. In this group, 16% saw their blood pressure rise instead of fall.
Doctors have long known that people respond differently to blood pressure medications. Until now, this has often been blamed on patients not taking their medicine correctly or random chance. However, this study suggests that the mismatch between a person’s renin level and their medication is a key reason for poor responses to treatment.
The researchers believe that testing renin levels before prescribing medication could help doctors choose the best drug for each patient. This approach may be especially useful for two groups: people taking blood pressure medicine for the first time and those who are on multiple medications when fewer might be just as effective.
By using renin testing to guide treatment, doctors may be able to reduce the risk of prescribing medications that worsen blood pressure instead of improving it. This study, led by Dr. Michael Alderman, was published in the American Journal of Hypertension.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more information about blood pressure, please see recent studies about How to eat your way to healthy blood pressure and results showing that Modified traditional Chinese cuisine can lower blood pressure.
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