Plasma renin activity was measured in 38 patients with essential hypertension in the following conditions:
1) at rest, supine position under normal sodium intake,
2) after 4 hours ambulation under normal sodium intake,
3) at rest, supine position after 4 days of sodium restricted diet (sodium intake was less than 30 mEq a day),
4) after oral administration of 80 mg furosemide and 4 hours ambulation under sodium restricted diet.
These patients were classified into three subgroups; low, normal and high PRA groups according to PRA levels after furosemide administration and 4 hours ambulation under sodium restricted diet.
Blood pressure, age, sex, known duration of hypertension, renal functions, findings of eye grounds, cerebrovascular disturbances, cardiac disturbances, sodium balance, urinary sodium excretion, hematocrit, serum sodium and potassium, blood urea nitrogen, serum creatinine were investigated in these three subgroups.
1) Forty-five % of the investigated patients with essential hypertension exhibited low plasma renin values,37% had normal values and 18% exhibited high renin values.
2) Low PRA was found more often in the older age group, in women and in cases with enlarged heart and longer duration of hypertension.
3) The hematocrit values were low in the following order: low, normal, and high renin groups. There was a statistically significant difference between low and high renin groups.
4) The sodium balance was negative in 67% of low renin cases. In the low renin cases daily excretion of sodium was greater than in high or normal renin cases even after the sodium intake was restricted.
5) There were no significant differences among these three groups as for systolic and diastolic blood pressure, PSP, GFR, BUN, serum Na and K and serum creatinine.
6) There were no significant differences among these three groups as for findings of eye grounds, myocardial disturbances, cerebrovascular disturbances and severeness of illness.
7) From these results, it can be assumed that the low renin cases were in the state of relative volume expansion. There was no evidence that low renin patients were relatively protected from development of cardiovascular complications.
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