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The pressor response to angiotensin ii and norepinephrine and the chronotropic response to isoproterenol in patients with low normal and high renin essential hypertension and primary aldo steronism


, : The pressor response to angiotensin ii and norepinephrine and the chronotropic response to isoproterenol in patients with low normal and high renin essential hypertension and primary aldo steronism. Yokohama Medical Journal 33(3): 269-276

The pressor response to angiotensin II (AII) and norepinephrine (NE), and the chronotropic response to isoproterenol (IS) were measured in 5 normotensive subjects (NT), 27 essential hypertensive patients (EH) with low, normal and high plasma renin activity (5 LREH, 17 NREH, and 5 HREH) and 3 hypertensive patients with primary aldosteronism (PA). In 3 PA patients these examinations were carried out repeatedly after removal of the adrenal adenoma. There was no significant difference in either the pressor response to each of AII and NE or the chronotropic response to IS between EH and NT; however, there was a significant positive correlation (r = 0.428, P < 0.05) between the pressor dose of AII and NE required to produce a rise of diastolic blood pressure by 20 mm Hg in EH. There was no significant difference in either the pressor response to AII and NE or the chronotropic response to IS among LREH, NREH and HREH. There was a significant correlation (r = 0.51, P < 0.01) between the pressor response to AII and plasma renin activity in EH. In PA, the pressor response to AII was significantly increased (P < 0.05) as compared with EH and each of LREH, NREH and HREH, and that to NE was also increased but it was not significant statistically (P < 0.1). The increase of pressor response to each of AII and NE was reduced after removal of the adenoma.

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