Renin and Hypertension Low renin and High Renin essential hypertension

  • Renin is enzyme secreted by juxtaglomerular cells of the kidney.
  • Hypertensives can be low renin essential
  • Hypertensives and high renin essential hypertensives.

Low renin essential hypertension :

  • 20% of pa­tients of essential hypertension have low renin es­sential hypertension.
  • When patients with low renin essential hypertension take sodium-rich diet,
  • their aldosterone suppression does not occur, lead­ing to hyperaldosteronism causing more sodium re­tention, volume expansion and high BP.
  • There is increased ‘mineralocor­ticoid production, leading to increased sodium reten­tion, which in turn causes renin suppression.
  • The ad­renal cortex of low renin hypertensives have increased sensitivity to angiotensin II.
Renin and Hypertension 1

hypertension and renin

Non modulating essential hypertension :

  • The adrenal or renal vascular responses to angiotensin II is not modulated by sodium intake.
  • The effect of an­giotensin II does not depend on sodium intake in these patients.
  • so salt intake should be low. –
  • There is insulin resistance.
  • Non-modulation is a genetic problem.
  • 30% of hypertensives are non-modulating essential hypertensives.
  • Plasma renin activity levels are normal to high.
  • – Kidneys are unable to excrete sodium appropriately

Treatment

  • ACE inhibitors and salt restriction.
  • High Renin Essential Hypertension (HREH)  15% of hypertensives have HREH.
  • There is increased adrenergic system activity.
  • Angiotensin receptor blockers may or may not be effective.

Salt intake:

  • Higher the salt intake more the BP es­pecially in primary aldosteronism, bilateral renal ar­tery stenosis, renal parenchymal disease, low renin essential hypertension.
  • Salt includes chiefly – Sodium Chloride Calcium

Sodium, Chloride and Calcium

  • NaCI increases blood pressure.
  • Na without chloride does not increase blood pres­sure.
  • Intracellular calcium can lead to hypertension .
  • Calcium _entry blokers are very potent Fntihypertensives.
  • Low calcium intake also results in hypertension.

Cell membrane defect:

  • Abnormalities of sodium transport occur.
  • There is abnormal accumulation of calcium in vascular smooth muscle leading to vaso­constriction and hypertension.
  • This defect is present in of hypertensives.

Insulin resistance :

  • is related to hypertension. In­sulin resistance is common in obesity and NIDDM.
  • Obesity and NIDDM are common in hypertensives. These together form the metabolic syndrome also called syndrome X.

DOWNLOAD OUR ANDROID APP

One of the 1st in India.High Quality Generic Medicine Portal Android Application for Online Oreder & Information.

For More Join Our Membership and Get Additional 25% off on Meds, also get MLM Benefits to get a permanent earning source.

Join Membership How to Search Medicine
Android App

We would like to keep you updated with special notifications.