Renin-sodium profile and its therapeutical implications in arterial hypertension.

In 35 patients with moderate or severe essential hypertension (EH) four groups could be identified by plasma angiotensin II (AII) (formula: see text) and by exchangeable sodium (ENa) (formula: see text) determination. In 6 patients with high AII (135.9 pg/ml +/- 26.29) and normal ENa (98.83% +/- 1.40) propranolol significantly lowered both blood pressure (BP) and AII, suggesting that these forms of EH are renin dependent. In 15 patients with normal AII (36.43 pg/ml +/- 2.27) and high ENa (124.23 +/- 2.78) and in 6 patients with low AII (8.36 pg/ml +/- 3.39) and high ENa (125.16% +/- 5.71) the maximal hypotensive effect was achieved after ENa reduction with thiabutazid. These forms of EH appear to be volume-sodium dependent. In 8 patients with increase of both AII (76.53 pg/ml +/- 5.72) and ENa (112% +/- 1.72), propranolol associated with thiabutazid lowered the BP, AII and ENa suggesting that these cases are mixed forms. ENa determination appears to be a reliable index for renin profiling; such a renin-sodium profile allows to identify some pathophysiologic forms of arterial hypertension.