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Original Research |

Reactive Hyperreninemia in Renovascular Hypertension After Angiotensin Blockade with Saralasin or Converting Enzyme Inhibitor

[+] Article, Author, and Disclosure Information

Saralasin (Eaton Laboratories, Norwich, New York) and SQ 20881 (E. R. Squibb and Sons, Princeton, New Jersey) were generously provided by their manufacturers.

▸Requests for reprints should be addressed to David B. Case, M.D.; Cardiovascular Center, New York Hospital-Cornell Medical Center, 525 East 68th Street; New York, NY 10021.

New York, New York

© 1979 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1979;91(2):153-160. doi:10.7326/0003-4819-91-2-153
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Baseline plasma renin activity and responses to saralasin and converting enzyme inhibitor SQ 20881 (teprotide) in 47 untreated patients with surgically correctable renovascular hypertension were compared to those in 100 patients with high- and normal-renin essential hypertensioopn. All 32 renovascular patients on normal sodium intake had high renin-sodium profiles and renin values ≥ 5 ng angiotensin l/mL·h, as compared to 20 of 64 with essential hypertension. Diagnostic discrimination was greatly enhanced by infusion of saralasin or SQ 20881, which elicited marked reactive hyperreninemia in 31 of 32 renovascular patients but in only two of 64 with essential hypertension. Reactive hyperreninemia appeared to be more a specific test for renovascular hypertension than depressor responses. Prior dietary sodium depletion abolished this specificity. The results suggest that after initial screening with renin measurements, testing with angiotensin blocking agents may be a useful secondary screening procedure for more invasive and definitive procedures.





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