本態性高血圧症におけるRenin-Angiotensin系に関する研究 ―血漿Renin活性の加齢の影響および長期食塩制限による変化について
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The initial purpose of this study is to classify high, normal and low renin essential hypertension, based on plasma renin activity (PRA) in supine or upright positions in different age groups. The second is to investigate the effect of long-term (4 weeks) sodium restriction (35 mEq/day) with constant intake of potassium (75 mEq/day) on the renin-angiotensin system, electrolytes and pressor response to angiotensin II (AT-II) in essential hypertensive patients. The study was performed on 78 normotensive subjects and 142 patients with essential hypertension. The results obtained were as follows. 1) PRA in supine and upright position in 34 young (below 30 years), 35 middle (30-59 years), and 9 old (over 60 years) normotensive subjects were 1.54 ± 0.12 (m ± SE) and 4.24 ± 0.59, 1.17 ± 0.13 and 2.88 ± 0.36, 0.52 ± 0.08 and 1.46 ± 0.25 ng/m?/hr, respectively. Thus, PRA was lower in the older subjects, and a significantly negative correlation was found between PRA and age. PRA in supine and upright position in 18 young, 102 middle and 22 old hypertensive patients were 1.69 ± 0.22 and 3.99 ± 0.51, 0.84 ± 0.14 and 1.77 ± 0.23, 0.47 ± 0.11 and 0.86 ± 0.19 ng/m? /hr, respectively. And a significantly negative correlation was found between PRA and age, as observed in normotensive subjects.2) A classification of high, normal and low renin essential hypertension was made based on the age of the patients, and their incidences were 4.9 per cent, 63.4 per cent and 26.1 per cent, respectively. The remaining 5.6 per cent was undetermined by our classification. 3) The effect of long-term (4 weeks) sodium restriction. a) PRA increased significantly after one week of sodium restriction, and it did not show a significant change thereafter. b) PRA was significantly lower in the patients whose mean arterial pressure was reduced over 10 mmHg than in the patients in whom the pressure reduction was less than 10 mmHg. c) A significantly negative correlation was found between basal PRA or PRA responsiveness (the degree of PRA increase following upright position) and the changes of mean arterial pressure after four weeks of sodium restriction. d) Serum potassium concentration significantly increased, while serum sodium concentration did not change significantly during sodium restriction. e) A blood pressure fall following sodium restriction was associated with a reduction of pressor response to angiotensin II (0.015 (μg/kg/min). No correlation was found between the degree of reduction and that of blood pressure fall. A significant positive correlation, however, was found between the pressor response and mean arterial pressure. This pressor response seems to be negatively correlated with the supine or upright PRA. f) Plasma angiotensinase activity increased significantly after one week of sodium restriction, and it did not change significantly thereafter. This change seems to be pressor response to anigotensin correlated with the reduction of II.
- 札幌医科大学の論文
- 1977-06-01
札幌医科大学 | 論文
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