What question did this study set out to answer?

To evaluate the functional role of the renin–angiotensin system and angiotensin II in mild essential hypertension before and during hydrochlorothiazide therapy.

January 1, 1978Clinical Science

Renin–Angiotensin System in Mild Essential Hypertension. the Functional Significance of Angiotensin II in Untreated and Thiazide-Treated Hypertensive Patients

View Full Paper

Ask AI

Bookmark

Why the study?

Does the responsiveness of the renin-angiotensin system determine the blood pressure response to thiazide treatment in patients with mild essential hypertension?

Population

25 patients with mild essential hypertension and 25 40-year-old control subjects.

Comparison

Hydrochlorothiazide followed by angiotensin II… vs Untreated, sodium replete state and healthy…

Design

Cohort

Follow-up

3 months

Authors

HIHans IbsenUppsala University ALA LethGlostrup Hospital HHH HollnagelUniversity of Copenhagen

Discussion

Member takes

Implication

May support adding angiotensin blockade in thiazide nonresponders; leaves open whether RAS responsiveness determines thiazide response.

Key Points

To evaluate the functional role of the renin–angiotensin system and angiotensin II in mild essential hypertension before and during hydrochlorothiazide therapy.
Assessed 25 patients born in 1936 with mild essential hypertension and 25 40-year-old normotensive controls for basal and post-frusemide plasma renin and angiotensin II concentrations.
Administered hydrochlorothiazide at a mean dose of 75 mg/day for 3 months to 21 hypertensive patients.
Infused the angiotensin II antagonist saralasin (5.4 nmol min⁻¹ kg⁻¹) before and during thiazide therapy to determine blood pressure reactivity.
Untreated patients exhibited normal baseline renin and angiotensin II levels, and saralasin infusion produced a paradoxical increase in mean arterial pressure.
Pre-treatment frusemide-stimulated and on-treatment plasma renin and angiotensin II concentrations were significantly higher in thiazide non-responders (n = 10) compared to responders (n = 11).
Saralasin infusion during thiazide therapy lowered mean arterial pressure in all 10 non-responders, whereas only 4 of 11 responders showed a borderline decline.

Structured PICO

Does the responsiveness of the renin-angiotensin system determine the blood pressure response to thiazide treatment in patients with mild essential hypertension?

Population

25 patients with mild essential hypertension (born in 1936, approximately 40 years old) and 25 40-year-old control subjects.

Intervention

Hydrochlorothiazide (mean dose 75 mg/day for 3 months) followed by angiotensin II blockade with saralasin infusion (5.4 nmol min−1 kg−1).

Comparator

Untreated, sodium replete state (baseline) and healthy control subjects.

Outcome

Mean arterial pressure response to angiotensin II blockade (saralasin infusion).surrogate

Thiazide-induced stimulation of the renin-angiotensin system counter-balances the hypotensive effect of thiazides in approximately 40% of treated patients with mild essential hypertension.

Cite This Study

Ibsen et al. (1978) studied this question.

synapsesocial.com/papers/6a70324fac440176ef28d83a https://doi.org/10.1042/cs055319s

Topics

Hypertension management

View Full Paper

Ask AI

Bookmark

Renin–Angiotensin System in Mild Essential Hypertension. the Functional Significance of Angiotensin II in Untreated and Thiazide-Treated Hypertensive Patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Renin–Angiotensin System in Mild Essential Hypertension. the Functional Significance of Angiotensin II in Untreated and Thiazide-Treated Hypertensive Patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider