Prolonged Alteration of Renin Responsiveness after Spironolactone Therapy

AMONG patients with essential hypertension, a subset has been recognized as having characteristically low plasma renin activity (PRA). PRA is subnormal not only under ordinary circumstances but also under conditions designed to stimulate renin secretion. Thus, in this group of patients, plasma renin activity remains low even in response to the combined stimuli of furosemide and the assumption of upright posture.1 , 2 The correct identification of patients with the syndrome of "low-renin essential hypertension" is useful because chronic therapy with the mineralocorticoid antagonist, spironolactone, has repeatedly been shown to lower the blood pressure of patients with this condition.2 3 4 5 6 As the hypertension . . .