The urinary excretion of prostaglandins E2 and F2 alpha in essential hypertension.

The 24 h urinary excretions of prostaglandins E2 (E2/d) and F2 alpha (F2 alpha/d) were measured in twenty-five normal subjects and in thirty-five patients with essential hypertension [seventeen with low renin (LRH) and eighteen with normal renin (NRH) hypertension]. E2/d was lower in patients with LRH than in normal subjects (P less than 0.01), whereas no difference was found between patients with NRH and the controls. F2 alpha/d was similar in patients with LRH and in the normal subjects, but was significantly greater in patients with NRH (P less than 0.02). The ratio of prostaglandin E2 to prostaglandin F2 alpha was decreased in hypertensive patients (P less than 0.02), although in the NRH subgroup the difference was not statistically significant. It appears that LRH is associated with impaired production of prostaglandin E2, while a deranged relationship between the two prostaglandins exists in all the patients with essential hypertension. These changes in prostaglandin production could possibly contribute to the pathogenesis of hypertension, by increasing renal vascular resistance and decreasing sodium excretion. Alternatively, they might be a secondary phenomenon, reflecting changes in renal prostaglandin metabolism induced by the hypertensive state.