The Prognostic Implications of Plasma Renin in Essential Hypertension

IN 1972, the hypothesis was proposed that the chances of the major vascular complications of essential hypertension, myocardial infarction and stroke, developing in patients were directly related to the renin status of these patients.¹The basis for this thesis was the absence of such vascular complications over a ten-year interval among 59 of 219 hypertensive patients who had low plasma renin levels, compared to an incidence of such vascular disease in 11% of 124 patients with normal levels of renin whose mean blood pressures when not receiving therapy were identical. The authors do not claim that a low renin state promises immortality, and they have witnessed vascular complications "in a small proportion" of their group with low levels of renin,²but they have repeatedly presented their data as proof of their thesis that low renin levels protect against heart attacks and strokes.¹⁻⁵Moreover, two broad implications have been