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Bei 13 Patienten mit einem primaren Hyperaldosteronismus wurde die Plasma-Renin-Konzentration unter Stimulations- und unter Suppressionsbedingungen gemessen. Eine hochempfindliche Methode zur Reninmessung, die sich eines Radioimmunoassays fur Angiotensin I bediente, wurde verwandt.

Ein Radioimmunoassay fur Angiotensin I und seine Anwendung fur die Messung der Reninkonzentration im Plasma werden beschrieben. Die zur Herstellung von Angiotensinantikorpern und radioaktiv markiertem Angiotensin sowie zur Trennung von gebundenem und freiem Hormon benutzten Verfahren werden mitgeteilt. Die Empfindlichkeit der Methode erlaubt den Nachweis von zwanzig Pikogramm Angiotensin I.

Ten patients with benign essential hypertension were studied after sodium loads and during sodium depletion induced by diet and diuretic. Sodium intake of 400 mEq/day did not produce the expected fall in aldosterone secretion or supine plasma aldosterone concentration, which remained within or above the limits observed in normal men on an intake of 120 mEq of sodium. One patient with suppressed plasma renin activity (PRA), high urinary and plasma aldosterone and normal cortisol, had bilaterally enlarged adrenals containing small cortical nodules. Five other patients had low PRA, which did not rise normally on standing or during sodium deprivation, but could be stimulated by further diuretic-induced sodium loss. Two of these 5 cases, studied on a high sodium intake, had trivial increases in plasma aldosterone after standing, but the others had large postural increases without significant change in PRA, plasma cortisol, or plasma sodium or potassium concentration. PRA, aldosterone secretion rate an...

Plasma renin activity (PRA) and aldosterone secretion or excretion rates have been measured in 35 hypertensive patients. Most hypertensive patients respond normally to decreased sodium intake and upright posture with an increase in PRA, which is further enhanced when chlorothiazide is given. PRA was found to be above the normal range in malignant hypertension and in some patients with renovascular and essential hypertension. PRA remained increased for up to 2 months after taking estrogen and progestin. Subnormal PRA has been observed in primary aldosteronism and Cushing's syndrome. Six patients with essential hypertension had low PRA. When these patients were given a low sodium diet and chlorothiazide, neither PRA nor aldosterone increased normally, urinary sodium loss continued, and hyponatremia developed in 3 of the 6 patients. Postural hypotension was observed in 5 of the 6 cases during sodium depletion. Aldosterone secretion was well correlated with PRA in most hypertensives. Exceptions were ...

During the past two years, four reports have appeared, indicating that hypertension occurs in some women taking estrogengestagen combinations for control of conception or menstrual irregularities. Swaab (1) suggested that blood pressure could increase markedly during the use of oral contraceptives. Laragh (2) presented data on eleven patients with hypertension during contraceptive administration. In six of these patients, hypertension was first noted after starting medication. Six of the eight patients who stopped medication showed improvement or disappearance of the hypertension. In two cases, hypertension reappeared when medication was re-instituted. Woods (3) reported six patients with hypertension which was precipitated or aggravated by oral contraceptives.

16 patients out of 53 referred for hypertension were taking oral contraceptives at the time of referral and were studied for blood pressure differentials plasma angiotensinogen levels plasma renin activity (PRA) and aldosterone excretion rates (AER) after cessation of the contraceptive treatment. Of the 11 patients who had normal blood pressure before taking the estrogen-gestagen contraceptives all of them showed reduced blood pressure levels within 1-3 months of stopping the treatment. 5 returned to and maintained normal limits for 6 months or longer while the remaining 6 showed reduced blood pressure levels that remained above the upper normal limits. In the 3 women who were hypertensive before treatment blood pressure fell to control levels after discontinuation. Angiotensinogen (renin substrate) concentration in the plasma of the patients receiving oral contraceptives was 2-5 times normal concentration. This also caused increase in angiotensinogen generation. These levels returned to normal within 3 months of cessation of contraception. PRA and AER were 2 times the normal rates under contraceptive therapy. PRA decreased but remained high in some cases 3 months after the treatment was stopped while AER returned to normal within the same period. It is concluded that oral contraceptives can cause hypertension in some patients and aggravate a pre-existing condition in others. Blood pressure therefore should be followed carefully in patients receiving oral contraceptives.

Eleven women were found to be hypertensive while taking oral contraceptive preparations (OCP) containing estrogen and gestagen. Three months after discontinuing medication, blood pressure was normal in 4 of the patients (group A), was intermittently elevated or labile in 2 cases (group B), and remained persistently above normal in 5 cases (group C). While taking OCP, all 11 patients had elevated plasma angiotensinogen (renin substrate). Plasma renin activity (PRA) was significantly increased by oral contraceptives in all 3 groups of patients. Plasma renin concentration (PRC) was profoundly suppressed in groups A and B while taking OCP. PRC was significantly reduced in hypertensive women of group C but not to the same extent as in groups A and B. After stopping OCP for 3 months, all patients had normal levels of renin substrate in plasma. PRA fell into the normal range in all groups after stopping OCP. PRC increased in all groups after stopping OCP but did not reach average normal levels in groups A and B....