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What is the incidence of suppressed renin activity and normokalemic primary aldosteronism in normokalemic patients with benign essential hypertension?
What is the incidence of suppressed renin activity and normokalemic primary aldosteronism in normokalemic patients with benign essential hypertension?
Suppressed plasma renin activity is common in benign essential hypertension and occurs more frequently than normokalemic primary aldosteronism, limiting the diagnostic value of casual PRA measurements.
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Suppressed PRA occurs frequently without aldosterone excess; leaves open its diagnostic utility and subtype classification in essential hypertension.
In 35 normokalemic Negro patients with benign essential hypertension, plasma renin activity (PRA) was measured by the method of Boucher and associates, while they were on regular diets, after ambulation, sodium restriction and thiazide medication, and again after rigid sodium depletion in the hospital. In nine (26%) inadequate PRA response was elicited even after the latter regimen. In only two of these (6%) was elevated excretion of aldosterone demonstrated. Suppressed PRA is commonly encountered in apparent benign essential hypertension and it occurs much more frequently than normokalemic primary aldosteronism does. Casual measurement of PRA in ambulatory patients is of little differential diagnostic value in primary aldosteronism.
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Creditor et al. (1968) studied this question.
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