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The Determinants of Plasma-Renin Activity in Essential Hypertension

MURRAY ESLER, F.R.A.C.P., Ph.D.; ANDREW ZWEIFLER, M.D., F.A.C.P.; OTELIO RANDALL, M.D.; STEVO JULIUS, M.D., SC.D; and VINCENT DeQUATTRO, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Murray Esler, F.R.A.C.P., Ph.D.; Baker Medical Research Institute; Commercial Road; Prahran, 3181, Victoria, Australia.


Ann Arbor, Michigan; and Los Angeles, California


© 1978 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1978;88(6):746-752. doi:10.7326/0003-4819-88-6-746
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Plasma-renin activity was studied, under different conditions of stimulation, in normal subjects and patients with essential hypertension. In normal subjects, three components of renin release, "basal," "neural," and "sodium-sensitive," could be delineated. Among the hypertensive patients, abnormal patterns of renin release were noted. The categorization of patients according to "plasma-renin status," however, differed with the conditions of testing, being dependent both on the pathophysiology of the essential hypertension and the character of the renin-releasing stimulus, specifically whether this stimulus elevated plasma-renin activity through a predominantly neural (upright posture) or non-neural mechanism (dietary sodium deprivation). Abnormal plasma-renin activity in essential hypertension resulted in part from disordered sympathetic nervous system function. Patients with mild hypertension and elevated plasma-renin activity exhibited increased neural stimulation of renin release, whereas in patients with low plasma-renin values, all three components of renin release, including the neural element, were diminished.

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