Postural augmentation of plasma renin activity. Importance in diagnosis of renovascular hypertension

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Abstract
Studies have been carried out on 9 surgically treated patients with renovascular hypertension. The level of peripheral renin activity is diagnostic of this disorder provided that the blood specimens have been drawn after the patient has been ambulatory for 4 hours. Blood samples drawn from the same patients, while they are still in bed after overnight recumbency, gave normal values in 4 of 9 studied. When it is thus determined that renovascular hypertension does indeed exist from a functional point of view, catheterization of the renal veins is indicated. Blood specimens should be drawn first with the patient recumbent and again after he has been in an upright position for 15 to 45 min. The source or sources of the elevated peripheral plasma renin activity is thus determined and the physician can make appropriate decisions regarding therapy. Similar studies can be employed in the postoperative period to evaluate the adequacy of surgical procedures.