Table 1.

PRA‐based app treatment recommendations for untreated and for treated but uncontrolled HTN

Current drug therapy	PRA, ng/mL/hr	Drug therapy recommendation
Untreated HTN
None	< 0.65	Anti‐V; titrate as needed
None	≥ 0.65	Anti‐R; titrate as needed
Treated, uncontrolled HTN
≥ 1 Anti‐V drug; no anti‐R drug	< 0.65	Titrate current anti‐V as needed If BP uncontrolled, add another anti‐V; titrate as needed
	0.65–6.5	Add anti‐R; titrate as needed
	> 6.5	Stop anti‐V if no compelling indication If BP uncontrolled, add anti‐R; titrate as needed
≥ 1 Anti‐R drug (ACE inhibitor/ARB), no anti‐V drug	< 6.5	Stop anti‐R if no compelling indication If BP uncontrolled, add anti‐V; titrate as needed
	≥ 6.5	Titrate anti‐R as needed If BP uncontrolled, add another anti‐R; titrate as needed
≥ 1 Anti‐R drug (β‐blocker/DRI/central α2‐agonists), no anti‐V drug	< 0.65	Stop anti‐R if no compelling indication If BP uncontrolled, add anti‐V; titrate as needed
	≥ 0.65	Titrate anti‐R as needed If BP uncontrolled, add another anti‐R; titrate as needed
≥ 1 Anti‐V drug + ≥ 1 anti‐R drug	< 0.65	Titrate current anti‐V as needed If BP uncontrolled, add another anti‐V; titrate as needed
	≥ 0.65	Stop anti‐V if no compelling indication If BP uncontrolled, titrate current anti‐R as needed If BP uncontrolled, add another anti‐R

ACE, angiotensin converting enzyme; Anti‐R (anti‐renin) drugs including ACE inhibitors, ARBs, β‐blockers, DRIs, and central α2‐agonists; Anti‐V (anti‐volume) drugs including diuretics, aldosterone receptor antagonists, calcium channel blockers, vasodilators, and α1‐blockers; ARB, angiotensin receptor blocker; BP, blood pressure; DRI, direct renin inhibitor; HTN, hypertension; PRA, plasma renin activity.