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Increased Plasma Renin Activity, Secondary Aldosteronism, and Hypertension

Increased Plasma Renin Activity, Secondary Aldosteronism, and Hypertension Abstract The measurement of peripheral plasma renin activity during the investigation of hypertension has proved useful in distinguishing between primary and secondary aldosteronism. In primary aldosteronism, plasma renin activity is low and does not increase during the administration of a low sodium diet or after the assumption of an upright posture, effects which are seen in normal subjects.1-3 Conversely, in hypertensive diseases associated with secondary aldosteronism, plasma renin activity is usually high, or may increase abnormally as a result of an upright posture or a reduction in arterial pressure.4-6 While these findings are usual in malignant and renovascular hypertension, plasma renin activity and the rate of aldosterone secretion are rarely increased in benign essential hypertension unless this is complicated by sodium deficiency resulting from salt-losing renal disease or from the administration of diuretics.7 Our patient with hypertension was unusual in that plasma renin activity and aldosterone secretion were References 1. Conn, J.W., and Rovner, D.R.: Suppression of Plasma Renin Activity in Primary Aldosteronism , JAMA 190:213-221 ( (Oct 19) ) 1964. 2. Stokes, G.S.: Plasma Renin Activity, Serum and Urinary Potassium and Faecal Sodium: Potassium Ratio in the Screening of Hypertensive Patients for Primary Aldosteronism , Aust Ann Med 17:84 ( (Feb) ) 1968. 3. Grim, C.E., et al: Childhood Primary Aldosteronism With Bilateral Adrenal Hyperplasia: Plasma Renin Activity as an Aid to Diagnosis , J Paediat 71:377-383 ( (Sept) ) 1967.Crossref 4. Cohen, E.G.; Rovner, D.R.; and Conn, J.W.: Postural Augmentation of Plasma Renin Activity: Importance in Diagnosis of Renovascular Hypertension , JAMA 197:973-978 ( (Sept 19) ) 1966.Crossref 5. Kaneko, Y., et al: Renin Release During Acute Reduction of Arterial Pressure in Normotensive Subjects and Patients With Renovascular Hypertension , J Clin Invest 46:705-716 ( (May) ) 1967.Crossref 6. Creditor, M.C., and Loschby, U.K.: Plasma Renin Activity in Hypertension , Amer J Med 43: 371-382 ( (Sept) ) 1967.Crossref 7. Ledingham, J.G.; Bull, M.B.; and Laragh, J.H.: The Meaning of Aldosteronism in Hypertensive Disease , Circ Res 21 (suppl 2):177-186 ( (July) ) 1967. 8. Kliman, B., and Peterson, R.E.: Double Isotope Derivation Assay of Aldosterone in Biological Extracts , J Biol Chem 235:1639-1648 ( (June) ) 1960. 9. Stokes, G.S., et al: Metabolic and Hormonal Studies in a Patient With Primary Aldosteronism Presenting With Acute Hypokalaemic Paresis Induced by Chlorothiazide , Aust Ann Med 17:148-155 ( (May) ) 1968. 10. Boucher, et al: New Procedures for Measurement of Human Plasma Angiotensin and Resin Activity Levels , Canad Med Assoc J 90:194, 1964. 11. Godard, C., et al: Plasma Renin Activity and Aldosterone Secretion in Congenital Adrenal Hyperplasia , Pediatrics 41:883-904 ( (May) ) 1968. 12. Lauler, D.P.: Preoperative Diagnosis of Primary Aldosteronism , Amer J Med 41:855-863 ( (Dec) ) 1966.Crossref 13. New, M.I., and Peterson, R.E.: Disorders of Aldosterone Secretion in Childhood , Pediat Clin N Amer 13:43-53 ( (Feb) ) 1966. 14. Winer, B.M., et al: Renin in the Diagnosis of Renovascular Hypertension Activity in Renal and Peripheral Vein Plasma , JAMA 202:121-128 ( (Oct) ) 1967.Crossref 15. Maxwell, M.H.; Lupu, A.N.; and Franklin, S.S.: Clinical and Physiological Factors Determining Diagnosis and Choice of Treatment in Renovascular Hypertension , Circ Res 21 (suppl 2): 201-210 ( (July) ) 1967.Crossref 16. Robertson, P.W., et al: Hypertension Due to a Renin-Secreting Renal Tumor , Amer J Med 43: 963-976 ( (Dec) ) 1967.Crossref 17. Bunag, R.D.; Page, I.H.; and McCubbin, J.W.: Neural Stimulation of Release of Renin , Circ Res 19:851-858 ( (Oct) ) 1966.Crossref 18. Mogil, R.A., et al: Renin Innervation and Renin Activity in Salt Metabolism and Hypertension , Amer J Physiol 216:693-697 ( (April) ) 1969. 19. Stokes, G.S.; Gentle, J.L.; and Goldsmith, R.G.: Effects of Treatment With Sympatholythic Drugs and Sympathectomy on Plasma Resin Activity and Urinary Aldosterone Excretion in Hypertensive Patients, Proc Aust Soc Med Res, to be published. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Increased Plasma Renin Activity, Secondary Aldosteronism, and Hypertension

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Publisher
American Medical Association
Copyright
Copyright © 1970 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1970.02100050161016
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Abstract

Abstract The measurement of peripheral plasma renin activity during the investigation of hypertension has proved useful in distinguishing between primary and secondary aldosteronism. In primary aldosteronism, plasma renin activity is low and does not increase during the administration of a low sodium diet or after the assumption of an upright posture, effects which are seen in normal subjects.1-3 Conversely, in hypertensive diseases associated with secondary aldosteronism, plasma renin activity is usually high, or may increase abnormally as a result of an upright posture or a reduction in arterial pressure.4-6 While these findings are usual in malignant and renovascular hypertension, plasma renin activity and the rate of aldosterone secretion are rarely increased in benign essential hypertension unless this is complicated by sodium deficiency resulting from salt-losing renal disease or from the administration of diuretics.7 Our patient with hypertension was unusual in that plasma renin activity and aldosterone secretion were References 1. Conn, J.W., and Rovner, D.R.: Suppression of Plasma Renin Activity in Primary Aldosteronism , JAMA 190:213-221 ( (Oct 19) ) 1964. 2. Stokes, G.S.: Plasma Renin Activity, Serum and Urinary Potassium and Faecal Sodium: Potassium Ratio in the Screening of Hypertensive Patients for Primary Aldosteronism , Aust Ann Med 17:84 ( (Feb) ) 1968. 3. Grim, C.E., et al: Childhood Primary Aldosteronism With Bilateral Adrenal Hyperplasia: Plasma Renin Activity as an Aid to Diagnosis , J Paediat 71:377-383 ( (Sept) ) 1967.Crossref 4. Cohen, E.G.; Rovner, D.R.; and Conn, J.W.: Postural Augmentation of Plasma Renin Activity: Importance in Diagnosis of Renovascular Hypertension , JAMA 197:973-978 ( (Sept 19) ) 1966.Crossref 5. Kaneko, Y., et al: Renin Release During Acute Reduction of Arterial Pressure in Normotensive Subjects and Patients With Renovascular Hypertension , J Clin Invest 46:705-716 ( (May) ) 1967.Crossref 6. Creditor, M.C., and Loschby, U.K.: Plasma Renin Activity in Hypertension , Amer J Med 43: 371-382 ( (Sept) ) 1967.Crossref 7. Ledingham, J.G.; Bull, M.B.; and Laragh, J.H.: The Meaning of Aldosteronism in Hypertensive Disease , Circ Res 21 (suppl 2):177-186 ( (July) ) 1967. 8. Kliman, B., and Peterson, R.E.: Double Isotope Derivation Assay of Aldosterone in Biological Extracts , J Biol Chem 235:1639-1648 ( (June) ) 1960. 9. Stokes, G.S., et al: Metabolic and Hormonal Studies in a Patient With Primary Aldosteronism Presenting With Acute Hypokalaemic Paresis Induced by Chlorothiazide , Aust Ann Med 17:148-155 ( (May) ) 1968. 10. Boucher, et al: New Procedures for Measurement of Human Plasma Angiotensin and Resin Activity Levels , Canad Med Assoc J 90:194, 1964. 11. Godard, C., et al: Plasma Renin Activity and Aldosterone Secretion in Congenital Adrenal Hyperplasia , Pediatrics 41:883-904 ( (May) ) 1968. 12. Lauler, D.P.: Preoperative Diagnosis of Primary Aldosteronism , Amer J Med 41:855-863 ( (Dec) ) 1966.Crossref 13. New, M.I., and Peterson, R.E.: Disorders of Aldosterone Secretion in Childhood , Pediat Clin N Amer 13:43-53 ( (Feb) ) 1966. 14. Winer, B.M., et al: Renin in the Diagnosis of Renovascular Hypertension Activity in Renal and Peripheral Vein Plasma , JAMA 202:121-128 ( (Oct) ) 1967.Crossref 15. Maxwell, M.H.; Lupu, A.N.; and Franklin, S.S.: Clinical and Physiological Factors Determining Diagnosis and Choice of Treatment in Renovascular Hypertension , Circ Res 21 (suppl 2): 201-210 ( (July) ) 1967.Crossref 16. Robertson, P.W., et al: Hypertension Due to a Renin-Secreting Renal Tumor , Amer J Med 43: 963-976 ( (Dec) ) 1967.Crossref 17. Bunag, R.D.; Page, I.H.; and McCubbin, J.W.: Neural Stimulation of Release of Renin , Circ Res 19:851-858 ( (Oct) ) 1966.Crossref 18. Mogil, R.A., et al: Renin Innervation and Renin Activity in Salt Metabolism and Hypertension , Amer J Physiol 216:693-697 ( (April) ) 1969. 19. Stokes, G.S.; Gentle, J.L.; and Goldsmith, R.G.: Effects of Treatment With Sympatholythic Drugs and Sympathectomy on Plasma Resin Activity and Urinary Aldosterone Excretion in Hypertensive Patients, Proc Aust Soc Med Res, to be published.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Feb 1, 1970

References