Are patients with essential hypertension and low renin protected against stroke and heart attack?
Are patients with essential hypertension and low renin protected against stroke and heart attack?
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原发性高血压和低肾素患者是否可以预防中风和心脏病发作？
DOI：
10.1016/0002-8703(73)90281-0
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发表时间：
1973
影响因子：
4.8
通讯作者：
A. Amery
中科院分区：
文献类型：
--
作者：
Roland Stroobandt;R. Fagard;A. Amery
将59例原发性高血压患者分为三组，分别测定其血浆肾素浓度（每日标准化条件下采血、体力活动、钠摄入量和药物治疗），并对已知的心血管疾病危险因素如性别、年龄、家族史、吸烟、肥胖、收缩压和舒张压、血浆胆固醇和血脂、在20名低肾素水平的患者之间没有显著差异（低于每毫升7个斯金纳单位），19名患者具有中等范围的肾素水平，（每毫升7至14 U），以及20名血浆肾素水平高的患者（每毫升14个单位或更多）。三组中中风和心脏病发作的发生率相同，无论心力衰竭和恶性高血压患者是否被纳入或排除在该系列中。因此，我们无法从我们的数据中找到支持这一假说认为，低肾素保护高血压患者免受中风和心脏病发作。本研究与Brünner及其同事1和Laragh及其同事4的研究之间的差异进行了讨论，试图解释这种分歧的趋势。人们认为，治疗条件不能从这个小规模的回顾性研究中得出，但需要大规模的前瞻性研究。
Fifty-nine patients with essential hypertension were divided into three tertiles based on their plasma renin concentration, determined on blood withdrawn in standardized conditions of day, physical activity, sodium intake, and drug treatment.The incidence of known risk factors for cardiovascular disease such as sex, age, family history, cigarette smoking, obesity, systolic and diastolic blood pressure, plasma cholesterol and lipids, did not differ significantly between the 20 patients with low renin levels (below 7 Skinner units per milliliter), the 19 patients with middle range renin levels (between 7 and 14 U per milliliter), and the 20 patients with high plasma renin levels (14 units per milliliter or more).The incidence of stroke and heart attack was the same in the three groups, irrespective of whether patients with heart failure and with malignant hypertension were included or excluded from the series.We therefore could not find from our data a support for the hypothesis which suggests that low renin protects hypertensive patients against stroke and heart attack. The differences between this study and the study of Brünner and associates1and Laragh and colleagues4are discussed in an attempt to explain this divergent tendency. It is felt that therapeutic conditions cannot be drawn from this small and retrospective study, but that large-scale, prospective studies are needed.