Renin-sodium profile and its therapeutical implications in arterial hypertension.
In 35 patients with moderate or severe essential hypertension (EH) four groups could be identified by plasma angiotensin II (AII) (formula: see text) and by exchangeable sodium (ENa) (formula: see text) determination. In 6 patients with high AII (135.9 pg/ml +/- 26.29) and normal ENa (98.83% +/- 1.40) propranolol significantly lowered both blood pressure (BP) and AII, suggesting that these forms of EH are renin dependent. In 15 patients with normal AII (36.43 pg/ml +/- 2.27) and high ENa (124.23 +/- 2.78) and in 6 patients with low AII (8.36 pg/ml +/- 3.39) and high ENa (125.16% +/- 5.71) the maximal hypotensive effect was achieved after ENa reduction with thiabutazid. These forms of EH appear to be volume-sodium dependent. In 8 patients with increase of both AII (76.53 pg/ml +/- 5.72) and ENa (112% +/- 1.72), propranolol associated with thiabutazid lowered the BP, AII and ENa suggesting that these cases are mixed forms. ENa determination appears to be a reliable index for renin profiling; such a renin-sodium profile allows to identify some pathophysiologic forms of arterial hypertension.
D000328:Adult; D000368:Aged; D000804:Angiotensin II / Q000097:blood; D001581:Benzothiadiazines; D004232:Diuretics; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use*; D012083:Renin / Q000097:blood*; D012964:Sodium / Q000378:metabolism*; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use*
D001581:Benzothiadiazines; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D000804:Angiotensin II; D012964:Sodium; D011433:Propranolol; D012083:Renin