本態性高血圧症における血漿Renin活性,血漿Aldosterone濃度についてめ研究

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  • Studies on Plasma Renin-Aldosterone Interrelationships in Essential Hypertension
  • 本態性高血圧症における血漿Renin活性,血漿Aldosterone濃度についての研究
  • ホンタイセイ コウケツアツショウ ニ オケル ケッショウ Renin カッセイ

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In order to investigate the role of the renin-angiotensin system on the regulation of aldosterone in essential hypertension, plasma renin activity (PRA), plasma aldosterone concentration (PAC), plasma cortisol concentration (PC) and circulating blood volume (CBV) were measured before and after the renin provocation test in 103 patients with essential hypertension and in 28 normal subjects. The subjects had discontinued taking their antihypertensive drugs at least one week prior to the study. In the morning, urine was voided and blood samples were obtained on a fasting condition in the supine position after bed rest for one hour. Then, the subjects took 80 mg of furosemide orally and the second blood sample was obtained after 3 hrs ambulation. Circulating blood volume was estimated in 6 normal subjects and 60 hype rtensives by the RISA method.<BR>The results were a s follows: 1) PRA levels decreased with age both in normal controls and hypertensives, while PAC did not decrease with age in either group. It is suggested that PAC is inappropriately high as compared with PRA level in the aged subjects.2) In the low renin group, PRA showed little rise after the provocation, but PAC elevated at the same degree as in normal subjects. In other words, a dissociation between PRA and PAC was found in the low renin group.3) Although there was no significant difference in PC between normal subjects and hypertensives, high PC values were revealed in some cases of the high renin group. It seems that ACTH may play a role in the regulation of aldosterone secretion in these patients.4) As to hematocrit, no significant difference was noted between normal subjects and hypertensives. The hematocrit in the low renin group was significantly lower than in normal subjects both before and after the provocation.5) Urine volume and sodium excretion after furosemide were lesser in hypertensives than in normal subjects. Among the renin subgroups, urine volume and sodium excretion were highest in the low renin group, in the normal renin group next, and in the high renin group the lowest.6) There was no statistically significant difference in CBV between normal subjects and hypertensives. But CBV was greatest in the low renin group and least in the high renin group. This fact suggests the relative increase in CBV in the low renin group.

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