Personalized Management Of Uncontrolled Hypertension

Easy and robust serum testing

Screening for secondary hypertension

Right drugs for right patients

Better hypertension control

Less cardiovascular events

Uncontrolled Hypertension

multiple causes of uncontrolled hypertension

Uncontrolled hypertension affects more than 50% of patients treated for their high blood pressure. Underlying causes are manifold and it is therefore challenging to identify the cause of inefficient blood pressure lowering therapy in clinical practice. Diagnostic tools that have been available so far to screen for frequent forms of secondary hypertension, like primary aldosteronism, suffer from interference with anti-hypertensive therapies resulting in the need for drug withdrawal before screening, resulting in very low screening rates. General practitioners frequently have to go the trial and error path when seeking to control hypertension in their patients. Without knowing the underlying molecular causes, this might result in frustration among patients, inappropriate drug prescriptions and also increases in the overall cardiovascular risk due to a long time to blood pressure control.

RAAS Triple-A™ assay

RAAS Triple-A™ profiling is a novel molecular tool that can be used to identify the cause of uncontrolled hypertension by a simple blood test. The analysis is based on a serum sample that is analyzed for a set of blood pressure regulating hormones (Angiotensin I, Angiotensin II, Aldosterone). Serum levels of these hormones are determined by a proprietary mass-spectrometry based procedure and are used to calculate the angiotensin based biomarkers PRA-S, ACE-S and the AA2-Ratio.

PRA-S: Angiotensin based marker for renin, the pacemaker enzyme of the renin-angiotensin-aldosterone system (RAAS). Renin is secreted by the kidney and is regulated by renal hemodynamics, fluid and salt balance as well as angiotensin II itself. Most anti-hypertensive drugs have direct or indirect effects on renin secretion.

ACE-S: Angiotensin based marker for the activity of angiotensin converting enzyme (ACE), which is the main vascular and systemic producer of angiotensin II. ACE-S is obtained by calculating the ratio between angiotensin II and angiotensin I. ACE-S in a patient sample is a measure for the pharmacologic efficacy of an ongoing ACE inhibitor therapy.

AA2-Ratio: The ratio of aldosterone to angiotensin II reflects the responsiveness of adrenal glands for angiotensin II. In primary aldosteronism, which affects up to 10 % of hypertensive patients, this ratio is increased because excess aldosterone secretion is largely independent of angiotensin II. In patients with essential hypertension treated with ARBs, the AA2-Ratio is suppressed and can be used to monitor drug efficacy.

Diagnostic Process

RAAS Triple-A™ analysis requires the collection of a serum sample of at least 0.5 ml. Patients should be on their standard anti-hypertensive treatment. With a bench stability of at least 8 hours at room temperature, the assay is highly robust and compatible with routine laboratory procedures. Samples may optionally be shipped or stored frozen until analysis, allowing interval workup of clinical routine samples as well as retrospective assessment of study samples, if needed.

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