Vasomotion of renal blood flow in essential hypertension. Oscillations in xenon transit

To assess the frequency and magnitude of phasic renal blood flow changes in essential hypertension, we applied an analytical method based on the estimation of power spectral density to xenon transit through the kidney. Despite similar age and gender distribution of the patients and exclusion of those with accelerated hypertension, mean renal blood flow was significantly lower in 100 patients with essential hypertension (299 +/- 8 ml/100 g/min) than in the 144 normal subjects (335 +/- 6 ml/100 g/min; p less than 0.001). Normalized power, the index of oscillatory behavior, was more than twice normal in patients with essential hypertension (p less than 0.001), but there was no difference in the frequency or cycle length of the oscillation. Two maneuvers that induced renal vasoconstriction, the application of cuffs to the thighs which were then inflated to diastolic blood pressure and an emotional provocation, reduced renal blood flow much more in patients with essential hypertension (p less than 0.01) in association with a striking increase in normalized power (p less than 0.001). The oscillations, which reflected not the phasic blood pressure change but rather the phasic change in renal perfusion, provided additional evidence that renal vasoconstriction plays an active role in the pathogenesis of essential hypertension.