High blood pressure, also known as hypertension, affects almost half of all Americans.
Many people don’t even know they have it. High blood pressure happens when blood pushes through the arteries with more force than normal.
If not treated, it can lead to serious health problems like heart attacks and strokes.
Blood pressure is measured with two numbers. The top number, called systolic, shows the pressure when the heart is pumping blood. The bottom number, called diastolic, shows the pressure when the heart is resting between beats.
A recent study from Yeshiva University has found something surprising about how we treat high blood pressure. Some medicines that are supposed to lower blood pressure might actually raise it in some people.
This unexpected reaction is called a “pressor response.” It shows that not everyone reacts the same way to these drugs, and treatment should be more personal.
The study was led by Dr. Michael Alderman and published in the American Journal of Hypertension. The researchers looked at a group of 945 people in New York City who all had high systolic blood pressure—140 mmHg or higher. None of them had taken blood pressure medicine before. The study took place from 1981 to 1998.
Each person in the study was given one of two types of common blood pressure drugs. One group got “R drugs,” which include beta blockers and ACE inhibitors. These work by lowering a substance called renin in the blood. Renin is an enzyme released by the kidneys that helps control blood pressure.
The other group got “V drugs,” like diuretics and calcium channel blockers. These drugs help lower blood pressure by reducing fluid in the body.
Before giving the drugs, researchers tested the patients’ renin levels. Then, after one to three months of treatment, they checked their blood pressure again.
The results were very interesting. The study showed that renin levels could help predict which drug would work best for each person. It also showed which patients might actually see their blood pressure go up—instead of down—after taking a certain drug.
About 7.7% of people in the study had a pressor response, meaning their systolic blood pressure went up by 10 points or more. This was most common in patients who had low renin levels but were given R drugs.
In fact, 16% of people in this group had this problem. The study showed that giving the wrong kind of drug—based on a person’s renin level—can make blood pressure worse.
Doctors sometimes think these reactions are just random or caused by patients not taking their medicine properly. But this study proves that the mismatch between drug type and renin level is the real cause.
Today, renin levels can be measured with a simple blood test. The researchers believe that testing renin levels could help doctors choose the best medicine from the beginning. It could be especially helpful for two groups of people: those who are starting blood pressure treatment for the first time, and those already taking multiple medications.
This personalized approach could help people get better results with fewer side effects. Although this kind of testing is not yet common, the study shows it has the power to improve how we treat high blood pressure.
With so many people affected by hypertension, using renin testing could make a big difference. It could help more people reach safe blood pressure levels and avoid serious health problems in the future.
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