Plasma Renin in Long-Term Diuretic Treatment of Hypertension: Effect of Discontinuation and Restarting Therapy

1982 ◽  
Vol 63 (2) ◽  
pp. 121-125 ◽  
Author(s):  
S. Swart ◽  
R. F. Bing ◽  
J. D. Swales ◽  
H. Thurston
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Juxtaglomerular Apparatus ◽  
Significant Rise ◽  
Renin Activity ◽  
Hypertensive Patients ◽  
Diuretic Treatment ◽  
Low Renin Hypertension ◽  
Before And After

1. Plasma renin activity, body weight and blood pressure were measured before and after 7 days' treatment with bendrofluazide in ten hypertensive subjects. They were then treated with bendrofluazide alone (5 mg daily) for a minimum of 3 years. The diuretic was then discontinued and the measurements were repeated before and again after 7 days with bendrofluazide. The results were compared with those obtained before chronic treatment with the diuretic. 2. Chronic diuretic treatment was associated with a persistent and progressive rise in plasma renin activity, that fell promptly to pretreatment levels when diuretics were discontinued. This was associated with significant weight gain but no immediate significant rise in blood pressure. 3. When acutely challenged with bendrofluazide the patients showed a greater increase in plasma renin activity on the second occasion than on the first. Three out of five patients with an initially subnormal response had normal responses after chronic diuretic treatment. 4. Chronic diuretic treatment increased the responsiveness of the juxtaglomerular apparatus in some hypertensive patients. 5. Classification of hypertensive patients into renin subgroups may be influenced by previous therapy, even when that therapy has been discontinued for 4 weeks. In particular ‘low renin hypertension’ may be masked by recent use of diuretics, as shown by three of the five patients in this subgroup in the present study.

Role of Prostaglandin in the Antihypertensive Mechanism of Captopril in Low Renin Hypertension

1980 ◽  
Vol 59 (s6) ◽  
pp. 141s-144s ◽  
Author(s):  
Keishi Abe ◽  
Toru Ito ◽  
Makito Sato ◽  
Toshiaki Haruyama ◽  
KO Sato ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Activity ◽  
Prostaglandin E ◽  
Hypertensive Patients ◽  
Endogenous Prostaglandin ◽  
Low Renin Hypertension ◽  
Prostaglandin System

1. The role of endogenous prostaglandins in the antihypertensive mechanism of the angiotensin converting enzyme inhibitor, captopril, was investigated. 2. An unequivocal reduction in blood pressure and significant increase in plasma renin activity and urinary prostaglandin E excretion were found after the captopril administration. 3. The changes in blood pressure, plasma renin activity and urinary prostaglandin E excretion induced by captopril were reversed after the inhibition of endogenous prostaglandin synthesis by indomethacin. However, the responses in low renin hypertension were different from those in normal renin hypertension. 4. In low renin hypertensive patients who responded to captopril, the hypotensive effect was abolished after the addition of indomethacin, whereas no marked change in blood pressure was induced by indomethacin in normal renin hypertensive patients. In contrast, plasma renin activity was markedly increased after captopril administration in normal renin hypertension, and no significant change was found in low renin hypertension. 5. Potentiation of the prostaglandin system seems to be a principal factor in the antihypertensive mechanism of captopril in low renin hypertension, and inhibition of the renin-angiotensin system is important in normal renin hypertensives. 6. The increase in renin release after the administration of captopril was inhibited by indomethacin, suggesting that an endogenous prostaglandin system may contribute to the short feedback mechanism of renin release.

scholarly journals PECULIARITIES OF HEMODYNAMIC AND METABOLIC INDICATORS IN PATIENTS WITH ARTERIAL HYPERTENSION AND CONCOMITANT OBESITY DEPENDING ON PLASMA RENIN ACTIVITY

2021 ◽  
Vol 9 (1) ◽  
pp. 46-53
Author(s):  
V.H. Psarova ◽  
M.M. Kochuieva ◽  
G.I. Kochuiev
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
High Plasma ◽  
Renin Activity ◽  
Stress System ◽  
Hypertensive Patients ◽  
Serum Aldosterone ◽  
Low Renin Hypertension ◽  
Automated Methods

The aim of the research: to evaluate the effect of plasma renin activity on the state of hemodynamic and neurohumoral parameters in obese hypertensive patients. Anthropometric, biochemical, automated methods of immune analysis, spectrophotometric, instrumental, statistical methods were used to examine 200 hypertensive patients with class I–II obesity aged 45–55 years. Patients were divided into two groups depending on plasma renin activity: the first group included 21 patients with low-renin hypertension, the second – 179 patients with high-renin hypertension. Patients with HRAH had higher blood pressure BP (DBP, p = 0.004, SBP and mean blood pressure, p<0.001 for both indicators), higher CIMT bifurcation (p = 0.003) and cPWV (p = 0.023), larger size of the left ventricle and its MM (p = 0.039) compared with patients with LRAH. The HRAH was associated with a more pronounced imbalance of the oxidative stress system – antioxidant protection, higher levels of leptin, total cholesterol and LDL cholesterol. In the absence of differences in glycemic levels, patients with HRAH had significantly higher insulin levels and more pronounced IR, as assessed by the HOMA index. Patients with low plasma renin activity had significantly lower serum aldosterone levels with significantly higher ARR levels than patients with high plasma renin activity. Features of cardiovascular remodeling and neurohumoral status depending on the phenotype of hypertension in patients with concomitant obesity have been established.

Sodium and Renin in the Hypertension of Early Renal Disease

1978 ◽  
Vol 55 (s4) ◽  
pp. 301s-303s ◽  
Author(s):  
S. F. Wong ◽  
M. I. Mitchell ◽  
V. Robson ◽  
R. Wilkinson
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Activity ◽  
Exchangeable Sodium ◽  
Hypertensive Patients ◽  
Body Build ◽  
Activity Response ◽  
Normal Controls

1. Plasma renin activity, response to saralasin and exchangeable sodium have been measured in 43 patients with early renal disease. 2. Blood pressure was directly proportional to plasma renin activity. However, mean plasma renin activity was lower in patients with renal disease than in normal controls. 3. Blood pressure fell in response to saralasin infusion in proportion to the pre-infusion plasma renin activity. 4. Exchangeable sodium in hypertensive patients with renal disease did not exceed that in normotensive patients in contrast to earlier reports. Discrepancies may arise from the difficulty in interpreting measured exchangeable sodium in relation to body build.

Angiotensin II Blockade before and after Marked Sodium Depletion in Patients with Hypertension

1978 ◽  
Vol 54 (1) ◽  
pp. 75-83 ◽  
Author(s):  
P. Van Hoogdalem ◽  
A. J. M. Donker ◽  
F. H. H. Leenen
Keyword(s):  
Blood Pressure ◽  
Angiotensin Ii ◽  
Plasma Renin Activity ◽  
Sodium Intake ◽  
Plasma Renin ◽  
Hypotensive Effect ◽  
Renin Activity ◽  
Mean Blood Pressure ◽  
Sodium Depletion ◽  
Before And After

1. Angiotensin II blockade before and after marked sodium depletion in patients with hypertension [unilateral renovascular (eight), bilateral renovascular (four) and essential (four)] was performed by intravenous administration of the angiotensin II antagonist Sar1-Ala8-angiotensin II (saralasin). 2. On normal sodium intake, saralasin decreased mean blood pressure by 8 mmHg in the unilateral renovascular group, by 6 mmHg in the bilateral renovascular group and increased it by 3 mmHg in the essential hypertensive group. After sodium depletion saralasin decreased mean blood pressure by 33 mmHg, 35 mmHg and 18 mmHg respectively. The saralasin-induced decrease in blood pressure significantly correlated with the log of the initial plasma renin activity. 3. Saralasin infusion decreased effective renal plasma flow (ERPF) in all three hypertension subgroups, both on normal sodium intake and after sodium depletion. Glomerular filtration rate decreased in direct relation to the hypotensive effect of saralasin but ERPF showed this relationship only after sodium depletion. On normal sodium intake saralasin increased filtration fraction by 17%, but decreased it by 7% after sodium depletion. 4. It is concluded that the hypotensive action of saralasin closely correlates with the value of circulating plasma renin activity, apparently independent of the aetiology of the hypertension. The decrease in ERPF during saralasin infusion in the patients on normal sodium intake seems mainly related to the agonistic activity of saralasin, but that after sodium depletion to the hypotensive effect of saralasin.

Reduced Plasma Renin Activity in Essential Hypertension: Effects of Blood Pressure, Age and Sodium

1976 ◽  
Vol 51 (s3) ◽  
pp. 185s-188s ◽  
Author(s):  
G. W. Thomas ◽  
J. G. G. Ledingham ◽  
L. J. Beilin ◽  
A. N. Stott
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Inverse Relationship ◽  
Plasma Renin ◽  
Renin Activity ◽  
Hypertensive Patients ◽  
Significant Inverse Relationship ◽  
Control Subjects ◽  
And Control

1. Supine plasma renin activity and its responsiveness to erect posture and frusemide were reduced in fifty-one patients with essential hypertension, compared with fifty-one age- and sex-matched control subjects. 2. Twenty-four hour urinary sodium excretion was similar in hypertensive patients and control subjects, but after intravenous frusemide hypertensive patients excreted significantly less sodium. 3. A significant inverse relationship between plasma renin activity and diastolic blood pressure was demonstrated in hypertensive patients and in normotensive control subjects. 4. A significant inverse relationship between plasma renin activity and age, independent of blood pressure, was shown in hypertensive patients and control subjects. 5. It is concluded that the reduced renin values found in essential hypertension are, in part, the result of the elevated blood pressure acting on the kidney.

Plasma Catecholamines and Renin Activity in Response to Exercise in Patients with Essential Hypertension

1975 ◽  
Vol 49 (5) ◽  
pp. 511-514
Author(s):  
J. Chodakowska ◽  
K. Nazar ◽  
B. Wocial ◽  
M. Jarecki ◽  
B. Skórka
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Plasma Catecholamines ◽  
Plasma Renin ◽  
Work Load ◽  
Renin Activity ◽  
Plasma Noradrenaline ◽  
Hypertensive Patients ◽  
Control Subjects

1. The effect of physical exercise on blood pressure, plasma catecholamines and plasma renin activity was studied in fourteen patients with essential hypertension and in eight healthy subjects. 2. Resting plasma noradrenaline and adrenaline and plasma renin activity of the hypertensive patients did not differ from those of the control subjects. 3. In response to graded exercise producing successive heart rates of 120, 140 and 160 beats/min, significantly greater increases of blood pressure were found in the patients than in the control subjects. 4. Plasma noradrenaline increased significantly in both groups at all levels of exercise, the responses being significantly greater in the hypertensive patients. 5. The mean arterial blood pressure was significantly correlated with plasma noradrenaline concentration in the control subjects but not in the hypertensive patients. 6. In the hypertensive group plasma adrenaline increased significantly after exercise at all work loads whereas, in the control group, significant increase occurred only at the highest work load. The differences in the response of the two groups were significant at each work load. 7. Plasma renin activity increased significantly after exercise at the heart rate of 120 beats/min, both in the hypertensive patients and in the control subjects. The magnitude of the response was similar in the two groups.

Effect of Pindolol on Blood Pressure, Plasma Renin Activity, and Catecholamines in Hypertensive Patients

1981 ◽  
Vol 21 (2-3) ◽  
pp. 79-83 ◽  
Author(s):  
IRENE GAVRAS ◽  
HARALAMBOS GAVRAS ◽  
CHARLES P. TIFFT ◽  
GLENN R. KERSHAW ◽  
MARGARET BRESNAHAN
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Activity ◽  
Hypertensive Patients ◽  
Pressure Plasma

Abnormal responses for blood pressure in children and adults with surgically corrected aortic coarctation

2000 ◽  
Vol 10 (4) ◽  
pp. 353-357 ◽  
Author(s):  
Michael Hauser ◽  
Andreas Kuehn ◽  
Neil Wilson
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Plasma Renin ◽  
Left Ventricular ◽  
Renin Activity ◽  
White Coat Hypertension ◽  
Before And After ◽  
Blood Pressures

AbstractBackgroundDespite successful surgical repair of aortic coarctation, life expectancy is reduced, and up to one-third of patients remain or become hypertensive. So as to characterize the responses for blood pressure, we have studied 55 patients with surgically repaired coarctation. Their mean age was 11.3 ± 5.97 years. We documented maximal uptake of oxygen, anaerobic threshold, plasma renin activity and blood pressures during a Bruce protocol treadmill test. The velocity across the site of repair as imaged by crosssectional echocardiography was measured before and after exercise. We measured the changes in heart rate and blood pressure subsequent to an infusion of 1 ug per kg of isoprenalin, monitoring blood pressure over 24 hours in all patients.ResultsWhen compared with 40 healthy age-matched controls, the patients with coarctation had a normal exercise capacity. Resting systolic blood pressures above the 95th percentile were present in 45% of the patients. Exercise-induced hypertension, and an elevation in the average systolic 24 hour blood pressures, were observed, but less frequently than elevated baseline values, suggesting that socalled white-coat” hypertension may be present in this population. Abnormal reactions and elevation of plasma renin activity were related to a history of paradoxical hypertension at the time of surgery. Attenuation of the circadian rhythm for blood pressure was a frequent finding, and may have implications in the development of long-term damage to end-organs. A high correlation was found between mean systolic blood pressure measured by 24 hour monitoring and left ventricular hypertrophy (r=0.65, p<0.05).ConclusionsAbnormalities in blood pressure occurred independently of significant mechanical obstruction. Despite successful surgical repair, abnormalities in the shape of the aortic arch, reduced sensitivity of baroreceptor reflexes, and neurohumoral factors may all contribute to the development of hypertension.

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