Weidmann P, Hirsch D, Beretta-Piccoli C, Reubi F C, Ziegler W H
Schweiz Med Wochenschr. 1976 Dec 4;106(49):1741-3.
Interrelations between blood pressure, circulatory volume, plasma renin activity (PRA) and urinary catecholamine excretion rates were studied in normal subjects and patients with benign essential hypertension. Mean plasma or blood volumes related to lean body mass, products of blood volume and the logarithm of PRA, and catecholamine excretion rates did not differ significantly as between normal and hypertensive subjects. In both normal subjects and hypertensive patients, blood pressure correlated positively with noradrenaline excretion rate (r = 0.40 and 0.36 respectively; p less than 0.025), but not with adrenaline excretion, circulatory volume or the volume-renin product. The logarithm of PRA correlated inversely with mean blood pressure in normal subjects (r = -0.40; p less than 0.001), but not in hypertensive patients; however, there was no convincing evidence of an inappropriate blood pressure-PRA relationship as a prominent feature in the hypertensive patients. PRA did not correlate with blood volume. Patients with low PRA relative to sodium excretion (21% of hypertensive population) were consistently normovolemic, but tended to be older and excreted less (p less than 0.025) adrenaline than normal or high-PRA patients. The patient subgroup with high PRA relative to sodium excretion (11% of population) was hypovolemic (p less than 0.02); despite this, urinary sodium output was high (172 +/- 64 meq/24 hr). These data reveal no evidence for major roles of PRA, circulatory volume and free peripheral catecholamines in the maintenance of benign essential hypertension. Low-PRA essential hypertension is usually not a hypervolemic state, but may reflect diminished adrenergic activity, factors associated with aging and effects of a high systemic pressure. High PRA in benign essential hypertension may be at least partly a consequence of hypovolemia resulting from high blood pressure-induced sodium diuresis.
在正常受试者和良性原发性高血压患者中研究了血压、循环血容量、血浆肾素活性（PRA）和尿儿茶酚胺排泄率之间的相互关系。与瘦体重相关的平均血浆或血容量、血容量与PRA对数的乘积以及儿茶酚胺排泄率在正常人和高血压患者之间无显著差异。在正常受试者和高血压患者中，血压均与去甲肾上腺素排泄率呈正相关（分别为r = 0.40和0.36；p＜0.025），但与肾上腺素排泄、循环血容量或容量 - 肾素乘积无关。在正常受试者中，PRA的对数与平均血压呈负相关（r = -0.40；p＜0.001），但在高血压患者中无此相关性；然而，没有令人信服的证据表明血压 - PRA关系不适当是高血压患者的突出特征。PRA与血容量无关。相对于钠排泄PRA较低的患者（占高血压人群的21%）始终血容量正常，但往往年龄较大，肾上腺素排泄量比正常或PRA高的患者少（p＜0.025）。相对于钠排泄PRA较高的患者亚组（占人群的11%）血容量不足（p＜0.02）；尽管如此，尿钠排出量较高（172±64 meq/24小时）。这些数据表明，PRA、循环血容量和游离外周儿茶酚胺在维持良性原发性高血压中无主要作用。低PRA原发性高血压通常不是高血容量状态，但可能反映肾上腺素能活性降低、与衰老相关的因素以及高系统压力的影响。良性原发性高血压中高PRA可能至少部分是高血压诱导的钠利尿导致血容量不足的结果。
