Laragh J H, Letcher R L, Pickering T G
JAMA. 1979 Jan 12;241(2):151-6.
Recent research shows that the renin-angiotensin-aldosterone axis either maintains or causes some or all of the high blood pressure of most patients and demonstrates anew that renin-sodium profiling defines this involvement. Performed with a serum potassium measurement, this now reliable test is useful for primary screening and then, in conjunction with renal vein renin studies or an aldosterone profile, for diagnosis or exclusion of surgically curable renovascular or adrenocortical hypertensions. For the remaining majority with essential hypertension, renin profiling exposes the relative participation of either vasoconstriction or volume factors, thereby guiding simpler, more specific, and predictably effective antirenin or antivolume treatments. Renin profiling identifies those in whom treatment should begin with a beta-blocker as opposed to a diuretic while not infrequently also providing baseline information about severity and prognosis in individual patients.
最近的研究表明，肾素-血管紧张素-醛固酮轴维持或导致了大多数患者的部分或全部高血压，并再次证明肾素-钠分析可确定这种关联。结合血清钾测量进行的这项现已可靠的检测，可用于初步筛查，然后结合肾静脉肾素研究或醛固酮分析，用于诊断或排除可通过手术治愈的肾血管性或肾上腺皮质性高血压。对于其余大多数原发性高血压患者，肾素分析揭示了血管收缩或容量因素的相对作用，从而指导更简单、更具特异性且可预测有效的抗肾素或抗容量治疗。肾素分析可确定哪些患者应以β受体阻滞剂而非利尿剂开始治疗，同时还常常能提供有关个体患者病情严重程度和预后的基线信息。
