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Incidence of suppressed renin activity and of normokalemic primary aldosteronism in hypertensive Negro patients.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Loschky, U. K. |
| Copyright Year | 1968 |
| Abstract | SUMMARY In 35 normokalemic Negro patients with benign essential hypertension, plasma renin activity (PRA) was measured by the method of Boucher and associates, while they were on regular diets, after ambulation, sodium restriction and thiazide medication, and again after rigid sodium depletion in the hospital. In nine (26%) inadequate PRA response was elicited even after the latter regimen. In only two of these (6%) was elevated excretion of aldosterone demonstrated. Suppressed PRA is commonly encountered in apparent benign essential hypertension and it occurs much more frequently than normokalemic primary aldosteronism does. Casual measurement of PRA in ambulatory patients is of little differential diagnostic value in primary aldosteronism. IN AN EARLIER publication from this laboratory,' an extraordinary incidence of suppressed plasma renin activity was reported in a population of hypertensive Negro patients. In this group of outpatients, plasma renin activity was determined on casual blood samples and again after sodium restriction and thiazide medication. In view of Conn's2-4 interpretation that decreased plasma renin concentrations in hypertension suggest nor-mokalemic primary aldosteronism masquerading as essential hypertension, this group of patients was studied further in an attempt to define the incidence of primary aldosteronism and to test the diagnostic significance of suppressed renin activity. To establish a true incidence rate, all 53 patients newly referred to the Investigative Hypertension Clinic for diastolic hypertension during the period of study were considered. After withdrawal for reasons indicated in table 1, 35 patients considered to have essential hypertension by criteria which we have described' remained and serve as the basis for this report. They were all Negroes, between the ages of 24 and 63 years, and of both sexes. In all, the course was benign, serum potassium levels in the untreated state were normal (above 3.6 mEq/L), and no clinical features distinguished the groups to be described from each other. Due to the criteria established for admission to our clinic, all of these patients were severely economically deprived. Procedure and Method Procedure Blood for determination of plasma renin activity was drawn at the time of first clinic visit, after the patients had been ambulatory for 4 hours; thus the stimulatory effect of the upright position upon renin production was acknowledged. If renin activity was demonstrated in the patients , the presence of primary aldosteronism was considered unlikely, and the patient was excluded from the study. Those remaining were instructed in the use of a 2 g salt … |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/37/6/1027.full.pdf |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/37/6/1027.full.pdf?download=true |
| PubMed reference number | 5653045v1 |
| Volume Number | 37 |
| Issue Number | 6 |
| Journal | Circulation |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Aldosterone Benign essential hypertension (disorder) Conn Syndrome Diastole Entity Handling - upright Exclusion Hyperaldosteronism Hypertensive disease Hyponatremia Muscle Rigidity Outpatients Patients Pulmonary Hypertension Renin Activity Measurement Serum potassium measurement Sodium Thiazides |
| Content Type | Text |
| Resource Type | Article |
