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Renin dependency of blood pressure in isolated systolic hypertension

A P Niarchos, J H Laragh

    The American Journal of Medicine
    |September 1, 1984
    PubMed

    Insights

    The renin system significantly influences high systolic blood pressure in isolated systolic hypertension. Measuring plasma renin activity helps predict treatment response to drugs like propranolol and captopril.

    Area of Science:

    • Cardiology
    • Endocrinology
    • Pharmacology

    Background:

    • Isolated systolic hypertension (ISH) is a common condition, particularly in older adults.
    • The renin-angiotensin system (RAS) plays a crucial role in blood pressure regulation.
    • Understanding the RAS's contribution to ISH is vital for effective therapeutic strategies.

    Purpose of the Study:

    • To investigate the role of the renin system in maintaining elevated systolic blood pressure in patients with ISH.
    • To assess the relationship between plasma renin activity and the blood pressure-lowering effects of propranolol and captopril.

    Main Methods:

    • A study involving 31 patients with ISH treated with propranolol and 22 patients with ISH receiving captopril.
    • Patients were categorized into high-renin, normal-renin, and low-renin groups based on baseline plasma renin activity.
    • Correlation analyses were performed to link plasma renin activity with blood pressure reduction.

    Main Results:

    • Propranolol's systolic blood pressure reduction was greatest in the high-renin group and smallest in the low-renin group, correlating with plasma renin activity.
    • Captopril demonstrated a significant decrease in systolic blood pressure, particularly in the high-renin group, also correlating with plasma renin activity.
    • Both beta-blockers and ACE inhibitors showed renin-dependent effects on blood pressure in ISH.

    Conclusions:

    • Plasma renin activity is a key indicator of the renin-angiotensin system's involvement in sustaining elevated systolic blood pressure in ISH.
    • These findings suggest that tailoring antihypertensive therapy based on renin status can optimize treatment outcomes for ISH patients.

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