Effect of Age on Active and Inactive Plasma Renin in Normal Subjects and in Patients with Essential Hypertension*

Nakamaru, Mitsuaki; Ogihara, Toshio; Higaki, Jitsuo; Hata, Takeshi; Maruyama, Anna; Mikami, Hiroshi; Naka, Toru; Iwanaga, Keiichi; Kumahara, Yuichi; Murakami, Kazuo

doi:10.1111/j.1532-5415.1981.tb01245.x

Cited by 23 publications

(12 citation statements)

References 27 publications

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“…The urinary excretion of aldosterone is also diminished in elderly people . [12,13] However, plasma levels of inactive renin were found to be similar in young and old normotensive people, [14,17] as were plasma levels of renin substrate [12,17] and ACE.l 7,19] Supine angiotensin II plasma levels were found to be similar in young and old normotensive peoplePO,21] or slightly decreased in older people.l 22]…”

Section: Aging and The Raasmentioning

confidence: 96%

“…The aged RAAS responds appropriately to stimulation by sitting in an upright position, [18] by restricting salt intake [12][13][14][15]18,23] (fig . 2) and by furosemide (frusemide)-induced volume depletion,l13, 14,16] as well as to inhibition by volume expanslon.P'll However, the magnitude of the response is lower in old people than in young people.…”

Section: Aging and The Raasmentioning

confidence: 98%

“…2) and by furosemide (frusemide)-induced volume depletion,l13, 14,16] as well as to inhibition by volume expanslon.P'll However, the magnitude of the response is lower in old people than in young people. [12][13][14][15][16]18,23,24] Thus, the age-related differences in plasma renin activity and aldosterone levels are more pronounced in stimulated conditions than under basal conditions. However, when expressed as a percentage of baseline value, the increase in plasma renin activity or aldosterone level was found to be similar in young and old people)23] This supports the view that the responsiveness of the RAAS might be relatively unaltered by aging, but conditioned by basal secretory activity.…”

Section: Aging and The Raasmentioning

confidence: 99%

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Changes in the Renin-Angiotensin-Aldosterone Axis in Later Life

1994

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The renin-angiotensin-aldosterone system (RAAS) is one of the main systems involved in the regulation of blood pressure and sodium homeostasis. In animal experiments and in humans, the plasma renin activity and aldosterone levels are reduced with aging. The age-related differences in plasma renin activity and aldosterone are more pronounced in stimulated conditions (when sitting in an upright position, when salt intake is restricted and when plasma volume is depleted) than under basal conditions. Age-related alterations of the kidney (glomerulosclerosis, decreased number of functional nephrons) might account for the age-related differences in the active to inactive plasma renin ratio. In the same way, a diminished synthesis of angiotensinogen by the liver could contribute to the decrease in the activity of the RAAS in aging. This is partially compensated for by increases in the density of angiotensin II receptors reported in elderly patients. Furthermore, aging is associated with a reduced adrenal responsiveness to angiotensin II, contributing to lower production of aldosterone and alterations of sodium homeostasis. Estradiol and progesterone help stimulate the secretion of renin. Reduced levels of these hormones at menopause also lead to reduced plasma renin activity. In relation to these findings, several studies have shown that reductions in blood pressure, induced by short or long term treatment with angiotensin converting enzyme (ACE) inhibitors, were more pronounced in old than young hypertensive patients. An insertion/deletion polymorphism in the ACE gene has been described; the genotype deletion/deletion of this gene has been reported to be closely associated with longevity. This result was unexpected since the same deletion polymorphism was also shown to represent a potent risk factor for myocardial infarction.

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Section: Aging and The Raasmentioning

confidence: 96%

Section: Aging and The Raasmentioning

confidence: 98%

Section: Aging and The Raasmentioning

confidence: 99%

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Changes in the Renin-Angiotensin-Aldosterone Axis in Later Life

1994

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“…From puberty to the age of 60, there is a gradual progressive decline in mean plasma renin activity and plasma renin levels during each decade of life in normal humans, but such changes may not be statistically significant due to the wide variation in individual values (Abe et al 1975;Crane & Harris 1976;Nakamaru et al 1981;Saruta et al 1980;Tsunoda et al 1986;Weidmann et al 1977;Zozaya et al 1983). However, by the sixth decade of life, mean plasma renin activity and plasma renin levels are significantly decreased to the lowest values observed in normal humans (Crane & Harris 1976;Saruta et al 1980;Tsunoda et al 1986;Weidmann et al 1975Weidmann et al , 1977Zozaya et al 1983).…”

Section: Adult-elderlymentioning

confidence: 99%

Age-Related Changes in the Renin-Aldosterone System

Bauer

1993

Drugs & Aging

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Age-related changes in the renin-aldosterone system in normal humans are well documented. The most pronounced changes are observed at the extremes of life: plasma renin activity and plasma aldosterone levels are highest in the newborn, and lowest in the elderly population. There is a close temporal and directional relationship between the age-related decrease in plasma renin activity and the age-related decrease in plasma aldosterone. The renin-aldosterone system is also influenced by sex and race. The activation of the renin-aldosterone system in newborns and infants probably represents an important physiological mechanism designed to maintain positive sodium balance. The decreases in plasma renin activity and plasma aldosterone levels observed in elderly persons are usually only modest, and are not associated with clinical alterations in fluid or electrolyte metabolism. The superimposition of a disease process, or the injudicious prescription of a drug, inhibiting renin release or angiotensin II production, could theoretically facilitate sodium wasting in newborns or infants, or precipitate hyporeninaemic hypoaldosteronism in older adults. The primary clinical importance of age-related changes in the renin-aldosterone system relates to its impact on the proper classification of an individual's renin-aldosterone profile when attempting to diagnose a clinical condition (e.g. low, normal or high renin hypertension). This is particularly true for newborns, infants and children to age 4, and for adults entering the sixth decade of life.

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“…Both plasma renin activity and plasma aldosterone concentrations are generally reduced with ageing [22][23][24]. These effects on the RAAS are more pronounced under conditions that stimulate RAAS activity such as the upright posture, salt restriction or plasma volume depletion [25]. However, when the increases in plasma renin activity or aldosterone concentrations produced by these stimuli are expressed as a percentage of baseline values, the increase is similar in young and older normotensives indicating that the circulating RAAS maintains the ability to respond to these stresses [26].…”

Section: The Renin-angiotensin-aldosterone System In Diabetic Patientsmentioning

confidence: 97%

Prevention of Macrovascular Disease in Type 2 Diabetic Patients: Blockade of the Renin-Angiotensin-Aldosterone System

Thomas

Tomlinson²

2008

CDR

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Type 2 diabetes is reaching epidemic proportions throughout the world, which has major health implications as such patients have considerably increased risk of coronary heart disease (CHD). The renin-angiotensin-aldosterone system (RAAS) is involved in a wide range of adverse effects that contribute to the pathogenesis of CHD in diabetic patients, including vascular haemodynamic regulation, oxidative stress and hypertrophy of vascular cells. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are widely used in clinical practice. In diabetic patients ACE inhibitors and ARBs both effectively lower blood pressure, particularly in combination with low-dose thiazide diuretics, and may be considered first line therapies in the treatment of diabetic hypertension. Additionally they have important renoprotective actions independent of their blood pressure-lowering action, which is of particular benefit in diabetic patients, who are at increased risk of developing nephropathy. ARBs are generally well tolerated, but ACE inhibitor therapy is associated with some side effects such as cough and both may result in hyperkalaemia. Blockade of the RAAS with these agents appears to play an important role not only in protecting from renal disease, but it may also help to reduce morbidity and mortality from certain vascular diseases in diabetic patients.

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Effect of Age on Active and Inactive Plasma Renin in Normal Subjects and in Patients with Essential Hypertension*

Cited by 23 publications

References 27 publications

Changes in the Renin-Angiotensin-Aldosterone Axis in Later Life

Changes in the Renin-Angiotensin-Aldosterone Axis in Later Life

Age-Related Changes in the Renin-Aldosterone System

Prevention of Macrovascular Disease in Type 2 Diabetic Patients: Blockade of the Renin-Angiotensin-Aldosterone System

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