REN and essential hypertension: Treatment of patients with low renin essential hypertension is similar to that of patients with essential hypertension; however, since it has been found that mineralocorticoid excess plays a role in this condition, the addition of mineralocorticoid receptor antagonists such as spironolactone and eplerenone are often effective. Patients with resistant hypertension may be very sensitive to low-dose mineralocorticoid receptor antagonists and provide significant blood pressure reductions, as approximately 60-70% of resistant patients are generally found to have low renin.