EVOLUTION STAGES OF LOW RENIN HYPERTENSION

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).

Keywords

• renin
• aldosterone
• adrenal hyperplasia
• enalapril