The Laragh Method states that there are only two final determinants of all long-term human blood pressure, whether normotension or hypertension: the body salt content and the plasma renin level. Laragh defines this interaction mathematically in the Blood Pressure Equation:

BP = (body salt-volume V content) X (plasma renin R level)

In this equation dietary salt provides the primary volume support for normal blood pressure and flow and plasma renin sustains normal blood pressure whenever enough salt-volume is not available. Thus, a rise in plasma renin after salt depletion maintains normal blood pressure levels - although at the cost of reducing flow to tissues.

Within this volume-vasoconstriction interactive equation, all human hypertension is sustained by abnormally high (sodium-volume V) X (plasma renin R) products, involving either a body salt excess relative to plasma renin levels, or excess plasma renin relative to body salt. Thus hypertension is sustained by either excess salt, excess renin, or subtle excesses of both renin and salt.

Accordingly, by using an ambulatory renin test to solve for renin in the blood pressure equation, it is possible to readily identify and correctly treat each patient. Those with low plasma renin levels have too much salt and are treated first with a natriuretic anti-V drug. Those whose plasma renin levels are not suppressed are treated first instead with an anti-renin R drug. This approach seeks to correct most hypertension by giving only one, correct V or R drug type daily for life for the large majority, while also preventing or arresting fatal renin-mediated vasculotoxic sequelae in the R patients. Moreover, renin testing of unresponsive patients already receiving multiple V and/or R drugs readily identifies whether excess V or excess R was the cause of each treatment failure.

The Laragh Method's analytical strategy corrects most hypertension (65-90%) by using one – or at most two – drugs a day for life instead of the 2-6 drugs given daily to 63% to correct only 67% in the large NHLBI-sponsored ALLHAT Trial and endorsed by JNC7.

The Laragh Method enables correct and superior treatment of all hypertension, thereby extending the useful life of millions of patients while using many fewer drugs. Moreover, by eliminating the use of unneeded antihypertensive drugs in each hypertensive patient and by using generic drugs, still lower costs – amounting to savings of many billions of dollars annually – are now a reality.



Contact

John Laragh, MD
Telephone: (212) 746-2206