The state of the renin-angiotensin-aldosterone system in various clinical forms of hypertension in aging

The authors' data give evidence for an early involvement of the renin-angiotensin-aldosterone system in the hypertension pathogenesis with aging. The elderly patients with the systolic hypertension variant showed marked hyporeninemia and hyperaldosteronemia, while those with the systolic-diastolic variant displayed an increased or normal plasma renin activity against moderately increased aldosterone concentration. There was a marked increase of plasma renin activity in the patients with the cardiac form and a high circulating aldosterone concentration with the cerebral form of hypertension. The results suggest a certain interrelationship between the clinical picture of the disease and the renin-angiotensin-aldosterone system. The latter must be taken into consideration when making decisions regarding therapy and prophylaxis of hypertension.