Increased Central Blood Volume: A Possible Pathophysiological Factor in Mild Low-Renin Essential Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 207s-210s ◽  
Author(s):  
S. Julius ◽  
M. Esler
Keyword(s):  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Blood Volume ◽  
Plasma Renin ◽  
Renin Activity ◽  
Total Blood Volume ◽  
Central Blood Volume ◽  
Total Blood ◽  
Low Renin Hypertension ◽  
Head Up Tilt

1. Patients with mild low-renin hypertension characteristically have increased central blood volume. The total blood volume is normal; the larger central blood volume reflects a shift of the blood from peripheral to central (cardiopulmonary) segments of the capacity system. 2. A relationship between central blood volume and plasma renin activity is demonstrable during tilting in normal and hypertensive subjects. In thirteen individuals there was a strong correlation between the decrease of the central blood volume and the increase in plasma renin activity in response to 12 min of 35° head-up tilt. 3. We propose that the elevated central blood volume causes greater stretch of cardiopulmonary mechanoreceptors and this in turn depresses renin release in mild low-renin hypertension.

Suppression of the Renin—Aldosterone System in Mild Essential Hypertension

1976 ◽  
Vol 50 (4) ◽  
pp. 269-276
Author(s):  
A. M. Khokhar ◽  
J. D. H. Slater ◽  
T. P. Jowett ◽  
N. N. Payne
Keyword(s):  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Extracellular Fluid ◽  
Young Men ◽  
Plasma Renin ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Renin Activity ◽  
Low Renin Hypertension ◽  
Head Up Tilt

1. Suppression of the renin—aldosterone system by expansion of the extracellular fluid volume with extra sodium and mineralocorticoid for 6 days was studied in nine young men with very mild essential hypertension and in ten normotensive young men. 2. Plasma renin activity, measured both supine and after 45° head-up tilt, and the renal excretion of aldosterone 18-glucuronide were similar in both groups. However, after expansion of the extracellular fluid volume, hypertensive patients showed much less suppression of both variables. 3. This difference persisted despite matching for an equivalent degree of expansion of the extracellular fluid volume as indexed by the change in body weight. 4. Administration of extra sodium and mineralocorticoid produced a greater proportional fall of renal aldosterone excretion than of plasma renin activity in both groups and this dissociation was significantly more marked in the hypertensive group. 5. We suggest that (i) a relative autonomy of the renin—aldosterone system may be relevant to the pathogenesis and/or perpetuation of essential hypertension and (ii) that the syndrome of low-renin hypertension is unlikely to be associated with ‘mineralocorticoid’ excess.

Interrelations among blood pressure, blood volume, plasma renin activity and urinary catecholamines in benign essential hypertension

1977 ◽  
Vol 62 (2) ◽  
pp. 209-218 ◽  
Author(s):  
Peter Weidmann ◽  
David Hirsch ◽  
Carlo Beretta-Piccoli ◽  
Francois C. Reubi ◽  
Walter H. Ziegler
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Blood Volume ◽  
Plasma Renin ◽  
Renin Activity ◽  
Urinary Catecholamines

Fluid-regulating hormones during exercise when central blood volume is increased by water immersion

1992 ◽  
Vol 262 (5) ◽  
pp. R779-R785 ◽  
Author(s):  
L. M. Sheldahl ◽  
F. E. Tristani ◽  
T. P. Connelly ◽  
S. G. Levandoski ◽  
M. M. Skelton ◽  
...  
Keyword(s):  
Atrial Natriuretic Peptide ◽  
Plasma Renin Activity ◽  
Natriuretic Peptide ◽  
Blood Volume ◽  
Arginine Vasopressin ◽  
Water Immersion ◽  
Plasma Renin ◽  
Plasma Aldosterone ◽  
Renin Activity ◽  
Central Blood Volume

To examine the influence of an increase in central blood volume with head-out water immersion (WI) on fluid-regulating hormones during exercise, 10 healthy men underwent upright leg cycle exercise on land and with WI. Venous plasma renin activity and plasma venous concentrations of atrial natriuretic peptide, plasma aldosterone, and arginine vasopressin were determined at exercise intensities corresponding to approximately 40, 60, 80, and 100% peak oxygen consumption (VO2) and at minutes 1 and 5 of seated rest recovery within each environment. Peak VO2 did not differ on land and with WI. Atrial natriuretic peptide concentration was higher (P less than 0.05) and plasma renin activity was lower (P less than 0.05) in water than on land at 40% peak VO2 through minute 5 of recovery. Plasma aldosterone and arginine vasopressin concentrations were lower (P less than 0.05) in water at peak exercise and at minutes 1 and 5 of recovery. Osmolality and plasma sodium and potassium concentrations during exercise were similar in water and on land. The results indicate that WI alters the circulating levels of several hormones involved in fluid and electrolyte regulation during exercise. These hormonal alterations can best be explained by stimulation of low-pressure baroreceptors and atrial stretch due to increased central blood volume with head-out WI.

Urinary Kallikrein Excretion and Plasma Renin Activity in Patients with Essential Hypertension and Primary Aldosteronism

1978 ◽  
Vol 55 (1) ◽  
pp. 51-55 ◽  
Author(s):  
A. Lechi ◽  
G. Covi ◽  
C. Lechi ◽  
A. Corgnati ◽  
E. Arosio ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Primary Aldosteronism ◽  
Renin Angiotensin System ◽  
Plasma Renin ◽  
Renin Activity ◽  
Urinary Kallikrein ◽  
Hypertensive Patients ◽  
Urinary Kallikrein Excretion ◽  
Low Renin Hypertension

1. The 24 h urinary excretion of kallikrein has been studied in 40 normotensive control subjects and in 74 age-matched patients with essential hypertension under similar conditions. By use of the renin-sodium index, hypertensive patients were divided into two subgroups: low-renin hypertension and normal-renin hypertension patients. Urinary kallikrein determinations were also obtained from six hypertensive patients with primary aldosteronism. 2. Urinary kallikrein was significantly lower both in patients with normal-renin and low-renin essential hypertension. Urinary kallikrein excretion was very high in the patients with primary aldosteronism. 3. In nine hypertensive patients β-adrenoreceptor-blocking therapy caused a significant decrease of plasma renin activity, but had no significant effect on urinary kallikrein excretion. 4. The results support the concept that low urinary kallikrein is likely to be a marker of essential hypertension. Under certain conditions its excretion is positively related to mineralocorticoid hormone concentrations but it is not primarily related to the renin-angiotensin system.

REDUCED PLASMA RENIN ACTIVITY IN ELDERLY SUBJECTS IN RESPONSE TO VASOVAGAL HYPOTENSION AND HEAD-UP TILT

1987 ◽  
Vol 16 (3) ◽  
pp. 171-177 ◽  
Author(s):  
ROSE ANNE KENNY ◽  
CALUM C. LYON ◽  
JOHN BAYLISS ◽  
STAFFORD L LIGHTMAN ◽  
RICHARD SUTTON
Keyword(s):  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Activity ◽  
Elderly Subjects ◽  
Head Up Tilt

Dependence of plasma renin activity on prostaglandin excretion in essential hypertension

1978 ◽  
Vol 102 (1) ◽  
pp. 120-122 ◽  
Author(s):  
Pauli Yuitalo ◽  
Heikki Vapaatalo ◽  
Timo Metsä-Ketelä ◽  
Timo Pitkäjärvi
Keyword(s):  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Activity

Diuretics in hypertension

1975 ◽  
Vol 13 (26) ◽  
pp. 101-103
Keyword(s):  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Thiazide Diuretic ◽  
Mild Hypertension ◽  
Antihypertensive Drugs ◽  
Antihypertensive Agents ◽  
Plasma Renin ◽  
Renin Activity ◽  
Thiazide Diuretics ◽  
Treatment Of Hypertension

Thiazide diuretics such as bendrofluazide and chlorothiazide have been used for nearly 20 years in the treatment of hypertension. They have been regarded as rather weak antihypertensive agents which could be used alone only in mild hypertension and otherwise as adjuvants to more potent drugs in more serious cases.1 There are however some patients with ‘essential’ hypertension who are very sensitive to diuretics and in whom the pressure may be brought down to normal by a thiazide2 or spironolactone3 even when it is initially considerably raised. Furthermore a few patients who are responsive to thiazides are strikingly unresponsive to non-diuretic antihypertensive drugs. Patients particularly likely to respond to a thiazide diuretic4 or spironolactone3 commonly have low plasma renin activity and this occurs in about 25% of patients with essential hypertension.5 Since plasma renin activity is not routinely estimated it is simplest to identify these patients by observing the response to an adequate trial of a thiazide.

Solitary Kidney and Ageing as Causes of Low Renin and Aldosterone Concentrations: Relevance to ‘Low-Renin’ Essential Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 177s-180s ◽  
Author(s):  
R. Gordon ◽  
Freda Doran ◽  
M. Thomas ◽  
Frances Thomas ◽  
P. Cheras
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Plasma Volume ◽  
Plasma Renin ◽  
Renin Activity ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Normotensive Subjects ◽  
The Mean

1. As experimental models of reduced nephron population in man, (a) twelve men aged 15–32 years who had one kidney removed 1–13 years previously and (b) fourteen normotensive men aged 70–90 years were studied. Results were compared with those in eighteen normotensive men aged 18–28 years and eleven men aged 19–33 years with essential hypertension. 2. While the subjects followed a routine of normal diet and daily activity, measurements were made, after overnight recumbency and in the fasting state, of plasma volume and renin activity on one occasion in hospital and of blood pressure on five to fourteen occasions in the home. Blood pressure was also measured after standing for 2 min and plasma renin activity after 1 h standing, sitting or walking. Twenty-four hour urinary aldosterone excretion was also measured. 3. The measurements were repeated in the normotensive subjects and subjects in (a) and (b) above after 10 days of sodium-restricted diet (40 mmol of sodium/day). 4. The mean plasma renin activity (recumbent) in essential hypertensive subjects was higher than in normotensive subjects. In subjects of (a) and (b) above, it was lower than normotensive subjects, and was not increased by dietary sodium restriction in subjects of (a). 5. The mean aldosterone excretion level was lower in old normotensive subjects than in the other groups, and increased in each group after dietary sodium restriction. 6. Mean plasma volume/surface area was not different between the four groups and in normotensive, essential hypertensive and nephrectomized subjects but not subjects aged 70–90 years was negatively correlated with standing diastolic blood pressure.

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