Mehanna M, et al. - Researchers assessed the clinical utility of plasma renin activity (PRA)-guided antihypertensive prescribing among European-American (EA) and African-American (AA) hypertensives via a systematic-phased-approach. A total of 134 EAs and 102 AAs enrolled in the Pharmacogenomics Evaluation of Antihypertensive Responses-2 (PEAR-2) trial were assessed for clinic systolic-BP (SBP) responses to metoprolol vs chlorthalidone following categorizing by baseline-PRA. They used data from PEAR2-AAs and multivariable linear regression models to estimate an optimal PRA cut-point. They performed a meta-analysis of two independent AA-cohorts to test the derived cut-point in AAs. Findings highlighted the effectiveness of PRA at the previously established 0.60-0.65 ng/ml/hour cut-point as a predictive biomarker of blood pressure (BP) response in EAs. However, PRA cut-point that could be used to guide antihypertensive selection in AAs could not be identified.