Erythrocyte ion transport as indicator of sensitivity to antihypertensive drugs.
Multiple ion transport defects have been characterized in red blood cell membranes from essential hypertensive patients. These seem to be biochemical markers of at least three different types of essential hypertension. A first type is characterized by low pump, low cotransport fluxes in erythrocytes. These hypertensive patients are apparently identical to the salt-sensitive, low-renin hypertensive patients, in whom low pump and cotransport seem to result from the presence of circulating endogenous ouabain-like and bumetanide-like factors. These hypertensive patients are sensitive to diuretic drugs and to vaso-relaxants with salidiuretic activity, as expected from a reduction in plasma volume and circulating levels of endogenous ion transport inhibitors. A second type of essential hypertension is characterized by increased red cell Na+:Li+ countertransport and [Na+, K+, Cl-] cotransport. These hypertensive patients tend to present normal or high plasma renin activity, disorders in lipid metabolism, and left ventricular hypertrophy. Hypertensive patients belonging to this group seem to be resistant to diuretic drugs but sensitive to vasorelaxants. A third type of essential hypertension is characterized by both high membrane sodium leak and high [Na+, K+, Cl-] cotransport in erythrocytes. Hypertensive patients in this group are resistant to diuretics, angiotensin-converting enzyme (ACE) inhibitors, calcium antagonists, and centrally acting drugs.
Garay
R
R
INSERM U2, School of Medicine, Créteil, France.
Senn
N
N
Ollivier
J P
JP
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D000818:Animals; D000959:Antihypertensive Agents / Q000494:pharmacology*; D002121:Calcium Channel Blockers / Q000494:pharmacology; D004351:Drug Resistance; D004912:Erythrocytes / Q000378:metabolism*; D006801:Humans; D017136:Ion Transport / Q000187:drug effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers