Why the study?
Does converting enzyme inhibition alter renin and renin substrate levels in severely hypertensive patients?
Does converting enzyme inhibition alter renin and renin substrate levels in severely hypertensive patients?
Converting enzyme inhibition in severely hypertensive patients increases renin release and decreases renin substrate release, with differences between radioimmunoassay and enzymatic assay reflecting increased substrate consumption.
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Converting enzyme inhibition was associated with higher renin and lower substrate in severe hypertension; leaves open clinical relevance pending controlled studies.
In 10 severely hypertensive patients, on a low sodium diet, converting enzyme inhibition increased plasma renin activity and decreased plasma renin substrate. The use of direct radioimmunoassays for both the enzyme and its substrate showed that the number of immunoreactive renin molecules increased from 11.3 +/- 4.9 to 31.7 +/- 25.3 pmol 1(-1) whereas the number of immunoreactive renin substrate molecules decreased from 1.04 +/- 0.35 to 0.74 +/- 0.16 mumol 1(-1). The direct radioimmunoassay for angiotensinogen gave higher values than the direct enzymatic assay, and during converting enzyme inhibition, the difference between both methods increased in proportion to the rise in circulating renin. It is concluded that the difference between the renin substrate radioimmunoassay, which measures angiotensinogen and des-angio I-angiotensinogen, and the renin substrate enzymatic assay which only measures "active" substrate, is an index of the increased consumption of renin substrate, in a situation where the fall in angiotensin II enhances renin release and decreases renin substrate release.
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Genain et al. (1982) studied this question.
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