Carotid sinus reflex control of renin release in hypertensive subjects with high renin secretion.

1. Carotid baroreceptor manipulation (neck-chamber technique) and passive head-up tilting were used in ten patients with renovascular hypertension and in five subjects with essential hypertension under diuretic treatment to study reflex control of renin secretion at high basal-renin production rates. 2. Reflex effects of carotid baroreceptor manipulation on renin secretion were only minor. During baroreceptor deactivation there was a moderate increase in mean arterial pressure, but an inconsistent change in the renal venous--arterial difference in plasma renin activity (PRA). 3. During baroreceptor stimulation there was a modest fall in mean arterial pressure and a marked rise in the renal venous--arterial difference in PRA. This was opposite to the fall which might have been predicted as a result of the sympathetic depressor influence of the baroreceptor stimulus. Conversely, tilting increased the venous--arterial PRA difference by about 200%. 4. It is concluded that when renin production rate is high carotid baroreceptors exert little control over renin release, just as when renin production is low. Reflex control of renin, however, is very active in subjects with a high renin production, probably due to receptors in the cardiopulmonary region.