Brooks C S, Talwalker R T, Kotchen T A
J Clin Endocrinol Metab. 1977 Feb;44(2):322-9. doi: 10.1210/jcem-44-2-322.
Plasma renin reactivity (PRR) is the rate of angiotensin generation in vitro after addition of exogenous renin to plasma. To evaluate the hypothesis that suppressed plasma renin activity (PRA) in patients with low renin essential hypertension may be related to an alteration of the kinetics of the in vitro renin reaction, PRR was compared in plasma of patients with low renin and normal renin essential hypertension. Prostaglandin A (PGA) inhibits renin, and PGA was also measured to determine if suppressed PRA may be related to increased PGA. Low renin and normal renin hypertension were defined by comparing PRA responses of 30 hypertensive patients and 16 matched control subjects to upright posture and furosemide (80 mg p.o.). Nine of 30 patients had low PRA. Compared to that in plasma of patients with normal renin hypertension, PRR was suppressed (P less than 0.005) during 30, 60, and 180 min incubations in the low renin patients. Overall, in the hypertensive patients, there was a significant positive correlation (r= +0.58; P less than 0.01) between PRR and the PRA response to furosemide. PGA in patients with low renin hypertension (0.86 ng/ml+/-0.06 SE) was less (P less than 0.05) than that in patients with normal renin hypertension (1.10 ng/ml+/-0.07) SE) and control subjects (1.18 ng/ml+/-0.10 SE); PGA of normal renin patients and control subjects did not differ (P less than 0.1). These results suggest that an alteration of the kinetics of the renin reaction may contribute to the apparent renin suppression in patients with low renin hypertension. Hypertensive patients with suppressed PRA also have low PGA.
血浆肾素反应性（PRR）是指在向血浆中加入外源性肾素后体外生成血管紧张素的速率。为了评估低肾素原发性高血压患者血浆肾素活性（PRA）受抑制可能与体外肾素反应动力学改变有关这一假说，对低肾素和正常肾素原发性高血压患者的血浆PRR进行了比较。前列腺素A（PGA）可抑制肾素，同时也检测了PGA，以确定PRA受抑制是否可能与PGA升高有关。通过比较30例高血压患者和16例匹配的对照受试者对直立姿势和呋塞米（口服80mg）的PRA反应来定义低肾素和正常肾素高血压。30例患者中有9例PRA较低。与正常肾素高血压患者血浆相比，低肾素患者在孵育30、60和180分钟时PRR受到抑制（P<0.005）。总体而言，在高血压患者中，PRR与对呋塞米的PRA反应之间存在显著正相关（r = +0.58；P<0.01）。低肾素高血压患者的PGA（0.86 ng/ml±0.06 SE）低于正常肾素高血压患者（1.10 ng/ml±0.07 SE）和对照受试者（1.18 ng/ml±0.10 SE）（P<0.05）；正常肾素患者和对照受试者的PGA无差异（P<0.1）。这些结果表明，肾素反应动力学的改变可能导致低肾素高血压患者出现明显的肾素抑制。PRA受抑制的高血压患者PGA也较低。
