Swales J D
Lancet. 1975 Jan 11;1(7898):75-7. doi: 10.1016/s0140-6736(75)91076-4.
A substantial group of patients with essential hypertension have abnormally low renin levels which respond poorly to stimulation. Important differences in response to therapy and in prognosis have been described between these and other hypertensive patients. It is suggested that the vascular changes of nephrosclerosis, which may be seen in both hypertensive and normal subjects, result in a reduction of afferent arteriolar distensibility, with impairment of basal renin secretion and responsiveness. This hypothesis accords with both of the known clinical characteristics of low-renin hypertension and with the known effect of arterial changes upon the activity of other baroreceptors.
相当一部分原发性高血压患者肾素水平异常低下，对刺激反应不佳。这些患者与其他高血压患者在治疗反应和预后方面存在重要差异。有人提出，在高血压患者和正常受试者中均可出现的肾硬化血管变化，会导致入球小动脉扩张性降低，进而损害基础肾素分泌和反应性。这一假说既符合低肾素性高血压的两个已知临床特征，也符合动脉变化对其他压力感受器活动的已知影响。
