{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:09:12Z","timestamp":1791346152244,"version":"4.3.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2017,5,8]],"date-time":"2017-05-08T00:00:00Z","timestamp":1494201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>About one-half of all hypertensive adults do not have their blood pressure controlled. They are often prescribed medications that conform to national guidelines but they continue to have elevated blood pressure. This public health problem might be improved by applying plasma renin guided therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A contributor to the public health problem of unsuccessfully treated hypertension is that the circulating renin\u2013angiotensin system (RAS) is not recognized in treatment guidelines as clinically relevant for the treatment of hypertension or as important as the body salt status for determining blood pressure levels. Another contributor to the problem is the lack of specificity in the package inserts for antihypertensive drugs. They do not specifically state under the heading \u201cIndications\u201d that RAS blockers are primarily most effective in hypertensive subjects with medium and high plasma renin levels; by contrast, natriuretic drugs are most effective in those with low plasma renin levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Literature review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>To address the problem of unsuccessfully treated hypertension, we recommend that the \u201cIndications\u201d section of package inserts for antihypertensive drugs be more specific. The primary indication for RAS blockers ought to be hypertension with medium and high plasma renin levels, and natriuretic agents for those with low plasma renin levels. Similar language ought to be added to treatment guidelines. Additionally, 3 other reasons for lack of blood pressure control also need to be addressed\u2014failure to prescribe antihypertensive drugs to hypertensive subjects, failure of patients to fill prescriptions, and low drug adherence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpx068","type":"journal-article","created":{"date-parts":[[2017,4,14]],"date-time":"2017-04-14T03:10:27Z","timestamp":1492139427000},"page":"857-860","source":"Crossref","is-referenced-by-count":1,"title":["Unsuccessfully Treated Hypertension: A Major Public Health Problem With a Potential Solution"],"prefix":"10.1093","volume":"30","author":[{"given":"Curt D","family":"Furberg","sequence":"first","affiliation":[{"name":"Division of Public Health Sciences, Wake Forest School of Medicine 1 , Winston-Salem, North Carolina , USA ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean E","family":"Sealey","sequence":"additional","affiliation":[{"name":"Department of Medicine, Weill Cornell Medical College 2 , New York, New York , USA ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon D","family":"Blumenfeld","sequence":"additional","affiliation":[{"name":"Department of Medicine, Weill Cornell Medical College 2 , New York, New York , USA ;"},{"name":"The Rogosin Institute 3 , New York, New York , USA ."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,5,8]]},"reference":[{"key":"2022111817460904000_CIT0001","first-page":"144","article-title":"Prevalence of hypertension and controlled hypertension\u2014United States, 2007\u20132010","volume":"62","author":"Gillespie","year":"2013","journal-title":"MMWR Suppl"},{"key":"2022111817460904000_CIT0002","first-page":"1","article-title":"Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011\u20132012","volume":"133","author":"Nwankwo","year":"2013","journal-title":"NCHS Data 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