Method for evaluating and treating hypertension

• US 6,595,926 B1
• Filed: 05/17/2001
• Issued: 07/22/2003
• Est. Priority Date: 09/07/2000
• Status: Expired due to Fees

• Current Assignee: John H. Laragh
• Original Assignee: John H. Laragh
• Inventors: Laragh, John H.
• Primary Examiner(s): Hindenburg, Max F.
• Assistant Examiner(s): Natnithithadha, Navin
• Application Number:
  US09/860,199
• Time in Patent Office: 796 Days
• Field of Search: 600/481, 600/483, 600/484, 600/485, 600/486, 600/490, 600/479, 600/454, 600/300, 600/301, 424/9.1, 424/9.2
• US Class Current: 600/481
• CPC Class Codes: A61P 9/12 Antihypertensives
• CPC Class Codes: G01N 2800/321 Arterial hypertension
• CPC Class Codes: G01N 2800/324 Coronary artery diseases, e.g. angina pectoris, myocardial infarction
• CPC Class Codes: G01N 2800/52 Predicting or monitoring the response to treatment, e.g. for selection of therapy based on assay results in personalised medicine; Prognosis
• CPC Class Codes: G01N 33/6893 related to diseases not provided for elsewhere
• CPC Class Codes: G16H 10/40 for data related to laboratory analysis, e.g. patient specimen analysis
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 40/63 for local operation

Abstract

The Laragh Method is a novel method useful for evaluating and treating hypertensive patients. The Laragh Method provides a systematic approach for the physician to use volume vasoconstriction information with entry and induced changes in blood pressure and in ambulatory plasma renin levels for the rational selection of treatment tailored to suit each individual hypertensive patient. The Laragh Method provides a systematic and rational approach to drug selection which greatly improves the therapeutic success rate among hypertensive patients and which for the large majority provides long-term blood pressure control with one drug instead of two or two instead of three with each drug rationally targeted to control the renin and/or volume elements in the blood pressure equation.

Claims

1. A method for evaluating and treating a patient experiencing a hypertensive crisis comprising:

a. obtaining a baseline laboratory profile comprising collecting blood from the patient to determine the patient'"'"'s baseline plasma renin activity (PRA) level;

b. (i) administering at least one anti-renin drug, and if the patient'"'"'s blood pressure does not respond after (b)(i),

(ii) administering at least one anti-volume drug;

c. establishing a tentative categorical diagnosis based on the response in steps b(i) and/or b(ii); and

d. confirming the categorical diagnosis after obtaining the results of the patient'"'"'s baseline PRA level.

2. The method of claim 1, wherein the laboratory profile further comprises obtaining a CBC.

3. The method of claim 2, wherein the laboratory profile further comprises obtaining a plasma catecholamine profile and an electrolyte profile.

4. The method of claim 3, wherein the laboratory profile further comprises obtaining the results of an ECG and an echocardiogram.

5. The method of claim 1, further comprising administering a drug which allows quantifunction of a neural factor.

6. The method of claim 5, wherein the drug is selected from the group consisting of phentolamine, esprodol, and labetalol, or any combination thereof.

7. The method of claim 1 wherein the anti-renin drug is selected from the group consisting of captopril and enlaprilet or a combination thereof.

8. The method of claim 7, wherein the anti-volume drug is furosemide.

9. The method of claim 5, wherein the neural factor is selected from the group comprising pheochromocytoma, cocaine abuse, and clonodine withdrawal.

10. The method of claim 1, further comprising administering a non-specific vasodilator.

11. The method of claim 10, wherein the non-specific vasodilator is selected from the group consisting of nicardipine, verapamil, nitroprusside, nitroglycerin, hydralazine, diazaoxide, or any combination thereof.

12. A method of evaluating and treating a patient experiencing a hypertensive crisis caused by a bleeding state, said method comprising:

a. obtaining a baseline laboratory profile comprising;

(1) collecting blood from the patient to determine the patient'"'"'s baseline PRA level; and

(2) performing at least one diagnostic test which suggest the presence of a bleeding state;

b. administering a beta blocker; and

c. confirming the diagnosis of the bleeding state by obtaining PRA results consistent with said diagnosis.

13. The method of claim 12, wherein the bleeding state is selected from the group consisting of cerebral dissection, aortic dissection, and acute myocardial infarction.