Holle R, Levy S B, Stone R A
Arch Intern Med. 1978 Oct;138(10):1514-9.
We investigated the possibility that variability in classification of patients with essential hypertension into low, normal, or high renin activity subgroups depends on the subject preparation that precedes the measurement of plasma renin activity (PRA). In 47 essential hypertensives, PRA was measured with patients supine and ambulatory who were receiving both an unrestricted dietray sodium intake and a low sodium diet. Additionally, PRA was determined following salt restriction, oral furosemide therapy, and ambulation. These results were compared, using several analytical techniques, to those of a group of age-, race-, and sex-matched normotensive controls. Extreme variability in classification was the rule, with only 28% of patients consistently classified as having normal PRA. No single approach provided maximal detection of both the low and high renin states. We conclude that renin classification of hypertensive patients requires a matched control population and that subtyping appears to be variable depending on diet, posture, and analytical approach.
我们研究了原发性高血压患者被分类为低肾素活性、正常肾素活性或高肾素活性亚组时存在差异的可能性，这种差异是否取决于血浆肾素活性（PRA）测量之前的受试者准备情况。在47例原发性高血压患者中，在患者仰卧和走动时测量PRA，这些患者同时接受不限量的钠摄入饮食和低钠饮食。此外，在限盐、口服速尿治疗和走动后测定PRA。使用几种分析技术将这些结果与一组年龄、种族和性别匹配的血压正常对照者的结果进行比较。分类存在极大差异是常态，只有28%的患者始终被分类为具有正常PRA。没有一种单一方法能够最大程度地检测到低肾素和高肾素状态。我们得出结论，高血压患者的肾素分类需要匹配的对照人群，并且亚型划分似乎因饮食、姿势和分析方法而异。
