Key result
Increasing age in patients with essential hypertension was associated with progressively reduced fluctuation of plasma renin activity in response to sodium chloride or thiazide treatment.
Why the study?
Does trichlormethiazide treatment alter endocrine and renal functions differently across ages in patients with essential hypertension?
Observational (n=149)
Does trichlormethiazide treatment alter endocrine and renal functions differently across ages in patients with essential hypertension?
In patients with essential hypertension, aging is associated with a progressive reduction in plasma renin activity fluctuation in response to sodium or thiazide treatment, likely due to impaired renal sodium and water excretion.
May identify thiazide-unresponsive hypertension phenotypes with age-related BP rise; leaves open whether endocrine markers guide therapy.
Endocrine and renal functions were studied in 149 patients with essential hypertension by measuring plasma electrolytes, renin activity, creatinine and aldoserone, as well as the urinary excretion of creatinine and sodium chloride, before and during treatment for hypertension. Half of the patients responded to trichlormethiazide (thiazide-responsive group) but the other half did not (thiazide-unresponsive group). Systolic and diastolic blood pressures increased progressively uith age in the thiazide-unresponsive group, but were lower and did not progress with age in the thiazide-responsive group. There was no consistent difference in plasma renin activity between the thiazide-responsive and the thiazide-unresponsive groups. The fluctuation of plasma renin activity in response to an excess of sodium chloride or to thiazide treatment was reduced progressively with age. Creatinine clearance decreased and the blood urea nitrogen level increased with age. The age-related decrease of plasma renin activity is discussed on the light of the age-related impairment in the ability of the kidney to excrete sodium and water.
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Yamada et al. (1979) conducted an observational in Essential hypertension (n=149). Age and thiazide responsiveness vs. Thiazide-unresponsive patients was evaluated on Endocrine and renal functions (including plasma renin activity and creatinine clearance). Increasing age in patients with essential hypertension was associated with progressively reduced fluctuation of plasma renin activity in response to sodium chloride or thiazide treatment.
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