The activity of the renin-angiotensin-aldosterone system in hypertensive and hydropic diseases
Many recent studies have shown 1) that aldosterone secretion and excretion and renin activity measurements vary in the same direction in response to the same stimuli, and b) that renin levels are under the control of at least four factors (1, 2). First, renin activity levels are closely, but inversely related to the sodium intake. This relationship is highly significant (“p”<0,01) and is present also for urinary sodium excretion. Secondly, angiotensin infusions, at non-pressor or at pressor rates, have a marked suppressive effect on renin levels. This inhibitory action is not due to the stress of the infusion, nor to the vasopressor effect of angiotensin, nor to its acute stimulation of aldosterone, since similar acute infusions of glucose 5% in water, nor-epinephrine and aldosterone will not affect blood renin levels. Thirdly, upright posture will result in a slight, but significant, increase in blood renin activity. Fourthly a prolonged and excessive aldosterone secretion, such as is seen in patients with primary aldosteronism due to adrenocortical adenoma will result in a marked suppression of blood renin activity levels.
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