J. CAULIE GUNNELLS JR., M.D., F.A.C.P.; W. L. MGGUFFIN JR., B.S.; IRWIN JOHNSRUDE, M.D.; R. R. ROBINSON, M.D., F.A.C.P.
One hundred eleven patients including 58 with normal renal arteries and 53 with renal artery lesions were studied with emphasis on the value of peripheral and renal venous plasma renin activity (PRA) to detect "significant" renovascular disease. The combination of an elevated peripheral PRA associated with a greater than twofold difference in renal venous PRA predicted the successful reduction in blood pressure in all patients with these combined abnormalities. A greater than twofold difference in renal venous PRA associated with a normal peripheral PRA was less reliable, predicting a reduction in blood pressure after surgery in only 50% of these patients. A rare patient with both normal peripheral and renal venous PRA has been shown to respond to surgery, and likewise an occasional patient with elevated peripheral PRA as well as an abnormal renal venous ratio will fail to achieve blood pressure reduction after surgery. In all patients with benign essential hypertension, normal peripheral PRA was observed with a wide scatter of individual renal venous PRA; however, a greater than twofold difference in renal venous PRA was noted in only 8%, thereby supporting the usefulness of renin values in these patients and providing a base line for comparison with other hypertensive diseases.
GUNNELLS JC, MGGUFFIN WL, JOHNSRUDE I, ROBINSON RR. Peripheral and Renal Venous Plasma Renin Activity in Hypertension. Ann Intern Med. ;71:555–576. doi: 10.7326/0003-4819-71-3-555
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Published: Ann Intern Med. 1969;71(3):555-576.
Cardiology, Coronary Risk Factors, Hypertension, Nephrology.
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