高血圧症における血清アンジオテンシンI・変換酵素活性とレニン・アンジオテンシン・アルドステロン系との関連

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In order to investigate the role and origin of serum angiotensin I-converting enzyme activity (ACEA) in hypertension, the correlation between serum ACEA and the renin-angiotensin-aldosterone system was evaluated in hypertensive patients of whom 36 had essential hypertension, five had hypertension associated with chronic renal failure, three had renovascular hypertension, and one had primary aldosteronism.<BR>Serum ACEA was 17.0 ± 3.3U (mean ± sd) in the normotensive control, 20.1 ± 7.1 U in patients with essential hypertension, 11.6 ± 3.4U in patients with chronic renal failure, 31.7 ± 1.1 U in patients with renovascular hypertension, and 9.7 U in primary aldosteronism in a recumbent state. There was a significant correlation between serum ACEA and plasma renin activity (PRA) (r= 0.615, p<0.001, n=45) and plasma aldosterone concentration (PAC) (r= 0.599, p<0.001, n = 34) in a recumbent state. However, there was no significant correlation between serum ACEA and mean blood pressure.<BR>Serum ACEA elevated with furosemide and an upright posture significantly correlated with elevation in PRA (r= 0.369, p<0.05, n=32) but did not significantly correlate with elevation in PAC.<BR>It is suggested, therefore, that the kidney is the suspected source of the plasma activity of the enzyme and that serum ACEA plays a possible role in the regulation of blood pressure and electrolyte metabolism modulating the renin-angiotensin-aldosterone system.
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高血圧症における血清アンジオテンシンI・変換酵素活性とレニン・アンジオテンシン・アルドステロン系との関連

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