STUDIES ON ESSENTIAL HYPERTENSION WITH SUPPRESSED PLASMA RENIN ACTIVITY: SODIUM EXCRETION PATTERN ON SALT RESTRICTION AND EFFECTS OF SPIRONOLACTONE ON BLOOD PRESSURE AND PLASMA RENIN ACTIVITY

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Based on the evaluation of plasma renin activity (PRA) responses to the two different maneuvers designed to produce hypovolemia; furosemide administration and dietary salt restriction, 12 hypertensive patients with a sup-pressed PRA were screened from 38 patients with benign essential hypertension. Urinary levels of aldosterone in these 12 patients were within normal limits. In five (group A) of 12 patients with a suppressed PRA the pattern of sodium excretion following salt restriction resembled that of five patients with primary aldosteronism. On the other hand, the remaining 7 patients (group B) showed the same pattern of sodium excretion following salt restriction as that of normotensive patients. All the patients of group A became normotensive within two weeks with spironolactone therapy with significant increases in the serum levels of potassium and PRA, while the patients of group B had an insignificant reduction of blood pressure without any changes in the serum levels of potassium and PRA for 7 weeks after spironolactone therapy. From these results it was suggested that there were at least two types of hypertension with a suppressed PRA, one was mineralocorticoid (other than aldosterone)-dependent (group A) and other one was not (group B).
社団法人日本循環器学会の論文
1973-02-20