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January 12, 1972Acta Medica Scandinavica

Angiotensin Ii Plasma Levels in Hypertensive Patients

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Why the study?

Does the plasma angiotensin II response to upright posture and furosemide differ among patients with various forms of hypertension and normotensive controls?

Population

Patients with hypertension, primary aldosteronism, and normotensive control patients

Comparison

Upright posture combined with an injection of… vs Normotensive control patients and patients with…

Design

Cross-sectional

Authors

FFFrej FyhrquistGeneral / Preventive / LipidsRKR KalaAmrita Institute of Medical Sciences and Research CentreCSC.‐G. Standertskiöld‐NordenstamMinerva Foundation

Discussion

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Overview

May support differentiation of secondary from essential hypertension; leaves open diagnostic utility pending prospective validation.

Key Points

  • To evaluate peripheral and renal venous angiotensin II responses to upright posture and furosemide across various clinical classifications of hypertension.
  • Measured peripheral venous plasma angiotensin II levels following upright posture and furosemide injection in normotensive controls and patients with essential hypertension, renal parenchymal disease, renal artery stenosis, malignant hypertension, or primary aldosteronism.
  • Sampled renal vein blood directly from affected kidneys in patients with unilateral renal disease and assessed postoperative hormone levels after adrenalectomy (n=3) or bilateral nephrectomy and transplantation (n=1).
  • Peripheral angiotensin II responses to posture and furosemide were markedly higher in patients with renal parenchymal disease, renal artery stenosis, or malignant hypertension than in patients with essential hypertension and normotensive controls.
  • Responses were suppressed to very low levels in primary aldosteronism, but plasma angiotensin II normalized following surgical resection of an adrenal adenoma in three patients.
  • Angiotensin II levels were markedly elevated in the renal veins of affected kidneys in unilateral renal parenchymal disease or stenosis, indicating local renal converting enzyme activity.

Structured PICO

Does the plasma angiotensin II response to upright posture and furosemide differ among patients with various forms of hypertension and normotensive controls?

P
Population
Patients with hypertension (essential, malignant, associated with renal parenchymal disease or renal artery stenosis), primary aldosteronism, and normotensive control patients
I
Intervention
Upright posture combined with an injection of furosemide
C
Comparator
Normotensive control patients and patients with essential hypertension
O
Outcome
Peripheral venous plasma angiotensin II (A-II) responsesurrogate

Plasma angiotensin II responses to posture and furosemide can help differentiate secondary forms of hypertension, such as renovascular hypertension and primary aldosteronism, from essential hypertension.

Cite This Study

Fyhrquist et al. (1972) studied this question.

synapsesocial.com/papers/6a8299dbc00c8d0185b27fbdhttps://doi.org/10.1111/j.0954-6820.1972.tb04855.x
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of Angiotensin Infusion on Catecholamine Uptake and Reactivity in Blood Vessels1971 · 54 citations
  2. 2Adrenal Medullary Stimulation Induced by Angiotensin I, Angiotensin II, and Analogues1971 · 83 citations
  3. 3Effect of Circulating Fragments of Angiotensin II on Radioimmunoassay in Arterial and Venous Blood1969 · 49 citations