Normal Plasma Renin Activity in Low Renin Hypertension

Modlinger, Robert S.; Gutkin, Michael

doi:10.1210/jcem-40-3-380

Cited by 10 publications

(2 citation statements)

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“…Of the 19 such subjects, 9 had low renin, 7 normal renin, and 3 high renin hypertension, as determined by their 1200 h erect PRA relative to their 24 h sodium excretion (6).…”

Section: Methodsmentioning

confidence: 99%

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The Circadian Rhythm of Renin

Modlinger¹,

Sharif-Zadeh²,

Ertel³

et al. 1976

The Journal of Clinical Endocrinology & Metabolism

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The circadian rhythm of plasma renin activity during continuous recumbency was determined fifty-one times in thirty subjects who either slept at night or remained awake for 24 h. Both groups had maximum values between 2400 and 0800 h, despite absence of the expected early morning fall in blood pressure, pulse, and glomerular filtration rate in the awake subjects. Infusion of normal saline between 2300 and 0300 h initially suppressed renin, but did not prevent its subsequent rise regardless of the amount of sodium appearing in the urine. Of thirteen patients tested two to five times, twelve had recurrence of the zenith within a single 4 h period on retesting, despite differences in sodium intake, basal blood pressure, and mean plasma renin activity. Peaks of lesser magnitude were also frequently noted, most commonly at 1000 h and 1800-2000 h. Minimum PRA values were not restricted to a particular time of day and did not generally recur at the same time upon retesting. The mean ratio of maximum to minimum PRA in each study was 246% +/- 18.3% (+/- 1 SEM). The circadian rhythm of renin appears to be independent of known renal mechanisms responsible for regulating renin release. It is possible that this rhythm is controlled by the central nervous system.

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“…Of the 19 such subjects, 9 had low renin, 7 normal renin, and 3 high renin hypertension, as determined by their 1200 h erect PRA relative to their 24 h sodium excretion (6).…”

Section: Methodsmentioning

confidence: 99%

“…Plasma renin activity (PRA) was determined as described previously (6,7). All samples from a single test date were incubated at the same time.…”

Section: Methodsmentioning

confidence: 99%

The Circadian Rhythm of Renin

Modlinger¹,

Sharif-Zadeh²,

Ertel³

et al. 1976

The Journal of Clinical Endocrinology & Metabolism

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Synergistic Effects of Hydralazine and Alpha‐ or Beta‐Adrenergic Blockers: The Role of Plasma Renin Activity

Gutkin¹,

Das²,

Chin³

et al. 1977

The Journal of Clinical Pharma

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Intravenous hydralazine, 0.15, 0.30 or 0.60 mg/kg, was administered to 11 supine hypertensives on two occasions: once after pretreatment with intravenous propranolol, 0.1 mg/kg, and once after pretreatment with intravenous placebo. The average fall in mean arterial pressure for each dosage of hydralazine was no different with or without propranolol, even though propranolol inhibited rises in plasma renin activity and pulse due to hydralazine. However, in each of four patients who had high supine baseline plasma renin activity, propranolol enhanced the fall in blood pressure caused by hydralazine. A second group of patients was given an infusion of 0.01 or 0.02 mg/kg per minute phentolamine, which did not change baseline blood pressure. Subsequent administration of intravenous hydralazine, 0.15 mg/kg, resulted in a fall in blood pressure which was larger than previously observed with intravenous hydralazine alone, regardless of supine baseline plasma renin activity. These data are consistent with the hypothesis that reflex catecholamine release interferes with the hypotensive effect of intravenous hydralazine. Pretreating with propranolol weakens homeostatic defenses against hydralazine such as rises in pulse rate and plasma renin activity. However, propranolol appears to enhance the alpha-adrenergic effect of released catecholamines, and the antihypertensive response to hydralazine is unaltered. In patients with high supine plasma renin activity, propranolol potentiates the fall in blood pressure induced by hydralazine, perhaps because the hypertension in such patients is renin dependent.

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Aldosterone and the Renin-Angiotensin System

Biglieri¹

1976

The Year in Endocrinology, 1975–1976

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Normal Plasma Renin Activity in Low Renin Hypertension

Cited by 10 publications

References 0 publications

The Circadian Rhythm of Renin

The Circadian Rhythm of Renin

Synergistic Effects of Hydralazine and Alpha‐ or Beta‐Adrenergic Blockers: The Role of Plasma Renin Activity

Aldosterone and the Renin-Angiotensin System

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