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Hypertension, Adrenal Abnormalities, and Alterations in Plasma Renin Activity

J. CAULlE GUNNELLS JR., M.D., F.A.C.P.; W. L. MCGUFFIN JR., M.D.; R. R. ROBINSON, M.D., F.A.C.P.; C. E. GRIM, M.D.; SAMUEL WELLS, M.D.; DONALD SILVER, M.D.; and J. F. GLENN, M.D.
[+] Article and Author Information

Supported in part by U.S. Public Health Service grants MO1 RR30 and HE 05848, National Institutes of Health, Bethesda, Md.

Presented in part January 1969 at the Southern Society for Clinical Investigation, New Orleans, La.; and July 1969 at the III International Congress of Nephrology, Stockholm, Sweden.

▸Requests for reprints should be addressed to J. Caulie Gunnells, Jr., M.D., Box 3014, Duke University Medical Center, Durham, N. C. 27706


Durham, North Carolina


Ann Intern Med. 1970;73(6):901-911. doi:10.7326/0003-4819-73-6-901
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Serial measurements of peripheral venous plasma renin activity were done in a group of patients with benign hypertension. Preoperative evidence of subnormal or suppressed plasma renin activity in response to a standardized protocol was demonstrated in 32 patients. Hypokalemia was present in 21 patients, and the other 11 patients had normal or variable concentrations of serum potassium. Urinary aldosterone excretion rates were increased in 19 patients and were normal or borderline-elevated in 13 patients. Adrenal exploration showed structural adrenal abnormalities in 90% of these 32 patients. After an average postoperative follow-up of 30 months, 23 patients (79%) had a satisfactory reduction in blood pressure; 6 patients remained hypertensive, and 3 patients who were followed less than 3 months were not included in the follow-up results. The diagnostic value and possible therapeutic indication of suppressed or subnormal plasma renin activity in the detection of adrenal abnormalities coexistent with benign hypertension are reviewed.

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