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™ PROFILING
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
RAAS Triple-A™ assay
RAAS Triple-ATM 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.
RAAS Triple-A™ profiling requires the collection of 8 ml blood into a standard serum tube. A resting period is not necessary before blood collection. The patient should remain on his standard anti-hypertensive therapy. Blood collection should be performed in the morning, ahead of taking the morning drug dose. The sample should be centrifuged 15 min after collection and then stored at room temperature until pickup by the laboratory service, which is required within 8 hours from sample collection. A sample submission sheet has to be completed before sample pick-up. Click here for more information.