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Low renin hypertension. A distinct entity.

H Thurston, J D Swales

    Lancet (London, England)
    |October 30, 1976
    PubMed
    Summary

    Essential hypertension may feature subnormal plasma renin activity (P.R.A.) responsiveness. Identifying a low-renin subgroup depends on whether absolute values or percentage rise after stimulation is used as the benchmark.

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    FAITH HEALING AND MIRACLES.

    British medical journal·2010

    Area of Science:

    • Nephrology
    • Cardiovascular Medicine
    • Endocrinology

    Background:

    • Conflicting reports exist regarding the identity of a low-renin subgroup in essential hypertension.
    • Understanding plasma renin activity (P.R.A.) distribution is crucial for classifying hypertensive patients.
    • Bendrofluazide stimulation is used to assess renin response in hypertensive individuals.

    Purpose of the Study:

    • To investigate the distribution of plasma renin activity (P.R.A.) in essential hypertension.
    • To resolve discrepancies concerning the definition of a low-renin subgroup in hypertension.
    • To compare P.R.A. responses to bendrofluazide stimulation between hypertensive patients and normotensive controls.

    Main Methods:

    • Examined plasma renin activity (P.R.A.) in 82 hypertensive subjects before and after bendrofluazide stimulation.
    • Compared unstimulated basal P.R.A. with 83 normotensive subjects.
    • Assessed post-stimulation P.R.A. in 38 hypertensive patients against age- and sex-matched normotensive controls.

    Main Results:

    • Unstimulated basal P.R.A. showed no distinct low-P.R.A. subgroup in hypertensives, though the distribution was right-skewed compared to controls.
    • The percentage rise in P.R.A. after bendrofluazide stimulation was less than half in hypertensive patients compared to controls.
    • Using absolute post-stimulation P.R.A. values identified a substantial group of patients with 'low renin hypertension'.

    Conclusions:

    • The identification of a low-renin subgroup in essential hypertension is critically dependent on the comparison standard used.
    • Subnormal P.R.A. responsiveness is a feature of essential hypertension when percentage rise is considered.
    • Defining a 'low renin hypertension' group based on absolute post-stimulation values is essentially arbitrary.

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