Objective: A significant proportion of hypertensive individuals display a low-renin profile and are commonly referred as subjects with low-renin-hypertension (LRH) phenotype. LRH is associated with a significant increase in cardiovascular events but it is debated whether it is more difficult to treat than non-low-renin hypertension (NLRH). Here, we investigated the prevalence of LRH and blood pressure (BP) control at 3 and 12 months in specialist centre in the UK. Design and method: Consecutive hypertensive subjects not on treatment with beta-blockers and centrally acting drugs were recruited from the hypertension outpatient service at Guy's and St. Thomas’ Hospital, London. Anthropometric variables, biochemistry assessment and BP measurement were evaluated in a baseline visit following which subjects were classified as LRH if renin concentration was < 5mU/L. Clinical data at 3 and 12 months were then used to assess BP control. Results: 205 patients ((mean±SD) age 44±13 years, 61% male) of whom 92% on pharmacological treatment were recruited. Prevalence of LRH was 28% and the two groups (LRH/NLRH) were similar in age, gender, body mass index, prevalence of diabetes and dyslipidaemia. Subjects with LRH (n=59) had higher systolic BP values compared to NLRH (156±23 mmHg vs 147±20 mmHg, P=0.013) whilst the difference was non-significant for diastolic BP (94±14 mmHg vs 91±14 mmHg, P=0.175). Decrease in systolic BP values were greater in LRH compared to NLRH at 3 months and 12 months (10.8±2.9 mmHg vs 5.1±1.6 mmHg and 13.1±3.4 mmHg and 6.3 ±1.7 mmHg respectively, both P< 0.05). with BP values at 12 months similar between the two groups (144±20/88±11 mmHg vs 141±16/89±12 mmHg for LRH and NLRH respectively, P=0.375, Figure 1). Treatment at 12 months differed in the two groups, with LRH patients more likely to be prescribed diuretics (39% vs 25%) and less likely to be prescribed ACE-i/ARB (39.0% v 61.4%), both P<0.05. Conclusions: LRH phenotype is common among patients evaluated in a specialist centre for hypertension. Despite higher BP values at the time of the encounter, LRH patients achieve similar levels of BP control compared to NLRH at 3 and 12 months during the follow up.