EVOLUTION STAGES OF LOW RENIN HYPERTENSION
https://doi.org/10.20996/1819-6446-2010-6-1-68-72
Abstract
Aim. To find out similarities and differences between various evolutionary stages of low rennin hypertension (LRHT), and to develop its diagnostic criteria.
Material and methods. Patients (n=190) with LRHT and the high cardiovascular risk were included into the study. All patients received ACE inhibitor, enalapril 10 mg twice a day, during 4 weeks. Before and after enalapril treatment plasma renin activity (PRA) and plasma aldosterone level (PAL) were determined by radioimmunoassay method in active patients. 24-hour urinary excretion of epinephrine (UEE) and norepinephrine (UENE) was also determined by laser flowmetry.
Results. Three forms of LRHT were defined among all patients: 1) patients (n=144) with essential LRHT had stimulated renin, eu- or hyperaldosteronism without adrenal hyperplasia; 2) patients (n=14) with transient LRHT had nonstimulated renin, eualdosteronism, presence or absence of adrenal hyperplasia; 3) patients (n=32) with the primary idiopathic hyperaldosteronism had nonstimulated renin, hyperaldosteronism and adrenal hyperplasia.
Conclusion. Three stages of LRHT evolution are found out. They have similar pathogenesis and different expression of morphofunctional changes in the juxtaglomerular complex and in the adrenal cortex as well as different respond to enalapril test (20 mg/daily).
About the Authors
S. V. Akhadov
City out-patient clinic N81
Russian Federation
Petrozavodskaya ul. 26A, Moscow, 125414
Russian Federation
Petrozavodskaya ul. 26A, Moscow, 125414
G. R. Ruzbanova
City out-patient clinic N81
Russian Federation
Petrozavodskaya ul. 26A, Moscow, 125414
Russian Federation
Petrozavodskaya ul. 26A, Moscow, 125414
G. S. Molchanovа
Moscow Regional Clinical Research Institute named after M.F.Vladimirsky
Russian Federation
Stchepkina ul. 61/2-2, Moscow, 129110
Russian Federation
Stchepkina ul. 61/2-2, Moscow, 129110
References
1. Ветшев П.С., Ипполитов Л.И., Соловьева Н.А. и др. Диагностика и хирургическое лечение первичного гиперальдостеронизма. Хирургия 2002;(9):7-16.
2. Gordon R.D, Stowasser M., Rutherford J.C. Primary aldosteronism: are we diagnosing and operating on too few patients? World J Surg 2001;25:941-7.
3. Mancia G., De Backer G., Dominiczak A. et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007;25(6):1105-87.
4. JohnstonC.I.,Mendelsohn F.A., Cubela R.B. et al. Inhibition of angiotensin converting enzyme (ACE) in plasma and tissues: studies ex vivo after administration of ACE inhibitors. J Hypertens Suppl 1988;6(3):S17-22.
5. Павленко А.К, Фадеев В.В, Мельниченко Г,А, Диагностика первичного гиперальдостеронизма. Проблемы эндокринологии 2001;(2):15-25.
6. Mosso L., Fardella C., Montero J. et al. High prevalence of undiagnosed primary hyperaldosteronism among patients with essential hypertension (in Spanish). Rev Med Chil 1999;127(7): 800-6.
7. Nishikawa T., Omura M. Clinical characteristics of primary aldosteronism: its prevalence and comparative studies on various causes of primary aldosteronism in Yokohama Rosai Hospital. Biomed Pharmacother 2000;54 Suppl 1:83s-85s.
8. Rayner B.L., Opie L.H., Davidson J.S. The aldosterone/renin ratio as a screening test for primary aldosteronism. S Afr Med J 2000;90(4):394-400.
9. Douma S., Petidis K., Doumas M. et al. Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study. Lancet 2008;371(9628):1921-6.
Review
For citations:
Akhadov S.V., Ruzbanova G.R., Molchanovа G.S. EVOLUTION STAGES OF LOW RENIN HYPERTENSION. Rational Pharmacotherapy in Cardiology. 2010;6(1):68-72. (In Russ.) https://doi.org/10.20996/1819-6446-2010-6-1-68-72
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