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[Arterial damage and the renin-angiotensin system in essential hypertension. Study of 63 cases]
Insights
Essential hypertension patients with low plasma renin activity (PRA) showed no reduced risk of cardiovascular events. Treatment for hypertension should commence promptly, irrespective of PRA levels, for optimal patient outcomes.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Context:
- Essential hypertension is a common condition with varying cardiovascular risks.
- Plasma renin activity (PRA) has been hypothesized to correlate with cardiovascular event risk.
- Previous research suggested lower risk for low-PRA hypertensives.
Purpose:
- To investigate the relationship between plasma renin activity (PRA) and cardiovascular events in essential hypertensive patients.
- To determine if low PRA levels confer a lower risk of myocardial infarction or cerebrovascular accidents.
Summary:
- This study analyzed 63 essential hypertensive patients, categorizing them into high, normal, and low PRA subgroups based on 24-hour sodium excretion.
- No significant differences in cardiovascular complications were found between high and low PRA groups.
- Coronary lesions were more prevalent in low-PRA subjects (80%) compared to normal-PRA subjects (37.5%) undergoing coronary angiography.
Impact:
- The findings challenge the notion that low PRA is protective against cardiovascular events in essential hypertension.
- This study underscores the importance of timely and effective hypertension management for all patients, regardless of their PRA status.
- Results suggest that PRA levels may not be a reliable indicator for stratifying cardiovascular risk in essential hypertension.
Abstract:
Brunner, Laragh et al. have suggested that essential hypertensives with low plasma renin activity (PRA) are at lower risk of myocardial infarction or cerebrovascular accidents than those with high or normal PRA levels. In this paper we report on 63 patients with essential hypertension in whom the relation between PRA and the ocurrence of cardiovascular events was studied. The patients were categorized in high (11%), normal (70%) or low (19%) PRA subgroups, according to their 24-hour sodium excretion. Coronary angiogram was performed in 24 subjects. The three subgroups showed no significant differences in diastolic blood pressure, serum cholesterol levels, smoking habits or obesity. The incidence of cardiovascular complications was similar in patients with high or low PRA levels (28.5% and 33.3% respectively). In those hypertensives in whom coronary angiogram was done, coronary lesions were observed in 80% of the low renin subjects and in 37.5% of those patients with normal PRA. Therefore, no relation between PRA levels and vascular complications was observed in this series of patients. It is conclude that patients with essential hypertension must be treated as soon and effectively as possible regardless of their PRA value.