Extracellular Fluid Volume and Renal Indices in Essential Hypertension

1979 ◽  
Vol 1 (5) ◽  
pp. 557-576 ◽  
Author(s):  
A. Ch. Simon ◽  
M. E. Safar ◽  
J. A. Levenson ◽  
N. E. Aboras ◽  
J. M. Alexandre ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Extracellular Fluid ◽  
Fluid Volume ◽  
Extracellular Fluid Volume

Plasma Volume and Extracellular Fluid Volume during Long-Term Treatment with Propranolol in Essential Hypertension

1972 ◽  
Vol 43 (2) ◽  
pp. 165-170 ◽  
Author(s):  
P. Sederberg-Olsen ◽  
H. Ibsen
Keyword(s):  
Essential Hypertension ◽  
Plasma Volume ◽  
Extracellular Fluid ◽  
Term Treatment ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Long Term Treatment ◽  
Significant Change

1. In ten patients with essential hypertension treated with propranolol (320 mg daily for 4 months) plasma volume and extracellular fluid volume were determined. 2. A significant increase in extracellular fluid volume (ECFV) was found, but there was no significant change in plasma volume. 3. The genesis of the increase found in ECFV is briefly discussed.

The Value of Plasma Renin Concentration Per Se, and in Relation to Plasma and Extracellular Fluid Volume in Diagnosis and Prognosis of Human Renovascular Hypertension

1970 ◽  
Vol 39 (5) ◽  
pp. 559-576 ◽  
Author(s):  
G. Bianchi ◽  
L. Campolo ◽  
A. Vegeto ◽  
V. Pietra ◽  
U. Piazza
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Renal Disease ◽  
Renovascular Hypertension ◽  
Extracellular Fluid ◽  
Plasma Renin ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Plasma Renin Concentration ◽  
Diagnosis And Prognosis

1. Plasma renin concentration (PRC) has been measured in 212 hypertensive patients. In fourteen patients with essential hypertension and in seventeen patients with renovascular hypertension, plasma volume (PV) and extracellular fluid volume (ECFV) were measured. 2. The results obtained have been discussed in three ways: (a) PRC in relation to the aetiology of hypertension; (b) PRC in relation to the effect on blood pressure of surgery for unilateral renal diseases; (c) PRC, PV and ECFV in ‘essential’ and renovascular hypertension. 3. Excluding patients with ophthalmoscopic signs of malignant hypertension, PRC is significantly higher in renovascular hypertension than in normal subjects and patients suffering from ‘essential’ hypertension and hypertension associated with bilateral renal disease; but the overlapping of the single values of the patients with these diseases is marked. Thus a normal PRC has no diagnostic value, while a high PRC without sodium deficiency or retinopathy might favour a diagnosis of renovascular disease. 4. In twenty-seven out of thirty-three patients submitted to surgery for unilateral renal disease and followed up for 12 months or longer, blood pressure has been significantly reduced. This group includes twelve patients with a normal preoperative PRC and fifteen patients with a high PRC. These results clearly demonstrate that unilateral renal disease may maintain a high blood pressure without increasing PRC and that PRC has no prognostic value. 5. Concurrent estimations of PRC, PV and ECFV in patients with renovascular or essential hypertension revealed the following differences. In cases of renovascular hypertension with normal PRC, PV and ECFV were significantly increased while in those with raised PRC, PV did not differ and ECFV was barely raised with respect to values obtained in patients with essential hypertension. PV of renovascular patients with normal renin was significantly higher than that of renovascular patients with high renin. The analysis of these results with quadratic discriminant functions demonstrated that an integrated evaluation of blood pressure, PV, ECFV and PRC allows a separation between the two types of hypertension. In other words these factors, taken together, in some way seem to reflect a difference between the two diseases. These results may indicate a new type of approach to the diagnosis and prognosis of renovascular 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.

Renin Suppression in Hypertension in Relation to Body Fluid Volumes, Patterns of Sodium Excretion and Renal Haemodynamics

1973 ◽  
Vol 45 (s1) ◽  
pp. 283s-286s ◽  
Author(s):  
M. A. D. H. Schalekamp ◽  
X. H. Krauss ◽  
G. Kolsters ◽  
M. P. A. Schalekamp ◽  
W. H. Birkenhäger
Keyword(s):  
Essential Hypertension ◽  
Vascular Resistance ◽  
Plasma Volume ◽  
Sodium Excretion ◽  
Extracellular Fluid ◽  
Fluid Volume ◽  
Renal Vascular Resistance ◽  
Extracellular Fluid Volume ◽  
Aldosterone Secretion ◽  
Renal Vascular

1. In patients with essential hypertension plasma renin concentration (PRC) was assessed in relation to age, plasma volume, extracellular fluid volume, aldosterone secretion rate, renal vascular resistance, filtration fraction and excess sodium excretion after acute salt loading. 2. Up to a calculated renal vascular resistance of 20 000 dyn s cm−5, PRC was found to be inversely related with the above-mentioned variables except plasma volume, extracellular fluid volume and aldosterone secretion rate. 3. It is concluded that the phenomenon of renin suppression is not dependent on mineralocorticoid excess. Instead, a decrease in PRC together with hypernatriuresis appears to reflect a progressive switch in intrarenal haemodynamic relationships. Renin suppression should therefore be considered to be a feature of progressive, but still uncomplicated, essential hypertension.

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