Essential hypertension: a metabolic cause? A hypothesis

Forty-five hypertensive patients, 28 women and 17 men, age range between 35 and 65 years (mean 50 years), with blood pressures which current therapy did not succeed to control, were submitted to several examinations in order to identify the cause of their hypertension. We found isolated or combined abnormal values of aldosterone, renin, calcium and or potassium as the only alterations in 19 patients. We distinguished 4 groups descretionally classified according to biochemical alterations: renin and aldosterone increase, renin increase, aldosterone increase, calcium and or potassium reduction. The therapy used, intentionally aimed at the correction of the biochemical alterations found. Normal blood pressure was achieved in all patients and simultaneously the biochemical alterations also became normal in patients with isolated hyperreninemia, with combined hyperreninemia and hyperaldosteronemia and in those with hypocalcemia and or hypopotassemia. In patients were only isolated hyperaldosteronemia was found, this condition returned to normal in all except one. We suggest that besides the disturbances in sodium distribution other electrolytes or biochemical alterations may also play an equally important role in regulating, and sustaining essential hypertension.