Summary of hypotheses investigated in the PATHWAY studies.
| Pathway | Hypothesis |
|---|---|
| 1 | Patients treated with a single drug never catch-up with the blood pressure control achieved with initial combination therapy, because of compensatory vasoconstriction or sodium retention. |
| 2 | Spironolactone is the best overall treatment for patients at step 4 of the NICE/BHS algorithm, and that the best drug for individual patients can be determined by measurement of plasma renin. |
| 3 | Multiple nephron blockade is more effective than single, and that addition or substitution of a potassium-sparing diuretic or thiazide in patients with features of metabolic syndrome will prevent deterioration of glucose tolerance. |