POSSIBLE ROLE OF RENIN IN HYPERTENSION AS SUGGESTED BY RENIN-SODIUM PROFILING AND INHIBITION OF CONVERTING ENZYME
POSSIBLE ROLE OF RENIN IN HYPERTENSION AS SUGGESTED BY RENIN-SODIUM PROFILING AND INHIBITION OF CONVERTING ENZYME
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DOI：
10.1056/nejm197703242961201
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发表时间：
1977-01-01
影响因子：
158.5
通讯作者：
LARAGH, JH
中科院分区：
文献类型：
--
作者：
CASE, DB;WALLACE, JM;LARAGH, JH
为了阻断肾素活性，我们给65例坐姿高血压患者服用了一种非肽转化酶抑制剂。只有当对照血浆肾素活性超过2 ng血管紧张素l/ml / h时，才会出现降压反应，且其幅度与对照血浆肾素活性和诱导的活性增量直接相关（两者均P < 0.001）。抑制反应，如肾素活性，是肾素亚组的特征，由肾素钠谱定义。钠剥夺前后，非肽降低了所有肾素高患者的舒张压（分别降低了17.3%和19.8%），大多数肾素正常患者的舒张压（分别降低了9.1%和17.7%）。低肾素患者仍无反应。这种酶阻断可能导致缓激肽积累。如果抑制反应是由于血管紧张素II形成的阻断，而不考虑钠平衡，血浆肾素活性的测量反映了它对血压维持的贡献。建议肾素系统广泛参与常见形式的高血压。
To block renin activity, a nonapeptide converting-enzyme inhibitor was given to 65 seated hypertensive patients. Depressor responses occurred only when control plasma renin activity exceeded 2 ng angiotensin l/ml per h and correlated directly in amplitude with control plasma renin activity and with induced increments in activity (P < 0.001 for both). Depressor responses, like renin activity, were characteristic for renin subgroups as defined by renin-Na profiling. Before and after Na deprivation, the nonapeptide reduced diastolic pressure in all patients with high renin (by 17.3 and 19.8%) and most patients with normal renin (by 9.1 and 17.7%). Low-renin patients remained unresponsive. This enzyme blockade may cause bradykinin accumulation. If depressor responses are due to blockade of angiotensin II formation, irrespective of Na balance, measurements of plasma renin activity reflect its contribution to blood-pressure maintenance. Broad participation of the renin system in common forms of hypertension is suggested.