Renin and myocardial infarction in hypertension

Article Abstract:

In the April 18, 1991 issue of The New England Journal of Medicine, researchers reported the results of an eight-year study to identify the role of the renin-sodium profile in the prediction of heart attack risk among patient with high blood pressure. The renin-sodium profile relates the blood pressure-regulating hormone renin with the excretion of sodium in the urine, and is a more useful indicator than the absolute concentration of renin. The researchers found that a high renin profile is associated with a higher risk of heart attacks, but not of stroke. However, more needs to be learned about the relation of the sodium-renin profile to heart attack risk. In the reported study, the researchers only measured the renin once at the beginning of the study. Furthermore, considering the 1,717 patients followed for an 8.3-year period, the observed number of heart attacks was 27, quite a low number. It is not known if how this unusually low number might influence the reliability of the results. It is also unclear from the published study how many patients might have been taking diuretic drugs and how the results of the study might have been influenced. The study did, however, indicate that the patients taking beta-blocking drugs had no advantage over those who were not; how, then, should the patients at apparently high risk be treated? It is tempting to suggest that the patients at high risk might be treated with angiotensin-converting-enzyme inhibitors, and yet it is already clear from other studies that the responsiveness to these drugs is not determined by the renin-sodium profile. The published work may well have identified an important risk factor for heart attacks among patients with hypertension, and the data seem to support the contention that the renin-angiotensin system is important in pathogenesis of heart disease. However, considerable research remains to be done to clarify the physiological issues involved and to determine how these data should actually be used to guide clinical practice. (Consumer Summary produced by Reliance Medical Information, Inc.)

Renin-angiotensin system, editorial

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Plasma renin activity and ischemic heart disease

Article Abstract:

Increased levels of plasma renin activity may not be associated with a higher risk of death from ischemic heart disease. Renin is an enzyme that helps the conversion of angiotensinogen to angiotensin. Angiotensin is a family of substances that induce blood vessel constriction. Eighty-six coronary events occurred in 803 men between 40 and 64 years of age. Fifty-one events were fatal, and 35 were non-fatal. No association was found between plasma renin activity and the risk of a heart attack or death from coronary causes. Among the 242 men with high blood pressure, the risk of a coronary event may be slightly higher for those with an increased level of plasma renin activity.

Coronary heart disease

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Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension

Article Abstract:

Patients with hypertension who have high blood pressure readings during 24-hour monitoring have an increased risk of heart attack, according to a study of 1,963 patients. All of the patients were taking medications to treat their high blood pressure. This indicates that even patients under treatment should have 24-hour blood pressure monitoring periodically.

Evaluation, Cooking, Patient monitoring, Physiologic monitoring, Cookery for hypertensives

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