Thurston H, Swales J D
Lancet. 1976 Oct 30;2(7992):930-2. doi: 10.1016/s0140-6736(76)90892-8.
In an attempt to resolve conflicting reports about the identity of a low-renin subgroup in essential hypertension, the distribution of plasma-renin activity (P.R.A.) has been examined in 82 hypertensive subjects before and after stimulation with bendrofluazide. The unstimulated basal P.R.A. showed no evidence of a separate subgroup of patients with low P.R.A. values although the distribution was slightly skewed with a tail to the right when compared with 83 normotensive subjects. In 38 of the patients post-stimulation P.R.A. observed in age and sex matched normotensive controls exposed to the same stimulus. However the percentage rise in P.R.A. in all 83 patients was less than half that of the controls. Thus the identification of a low-renin subgroup of hypertensive patients is critically determined by the standard of comparison employed: if the percentage rise is considered subnormal responsiveness is a feature of essential hypertension. If absolute post-stimulation values are used, there is a substantial group of patients with "low renin hypertension". The demarcation of such a group is, however, essentially arbitrary.
为了试图解决关于原发性高血压中低肾素亚组身份的相互矛盾的报告，我们在82名高血压患者中，检测了服用苄氟噻嗪前后的血浆肾素活性（P.R.A.）分布情况。未受刺激的基础P.R.A.没有显示出存在低P.R.A.值的单独亚组患者的证据，尽管与83名血压正常的受试者相比，其分布略有右偏态。在38名患者中，刺激后P.R.A.与年龄和性别匹配的血压正常对照者在接受相同刺激后观察到的情况进行比较。然而，所有83名患者中P.R.A.的升高百分比不到对照组的一半。因此，高血压患者低肾素亚组的识别关键取决于所采用的比较标准：如果将升高百分比视为低于正常水平，那么反应性降低是原发性高血压的一个特征。如果使用刺激后的绝对数值，就会有相当一部分患者属于“低肾素性高血压”。然而，这样一组患者的划分基本上是任意的。
