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[Arterial damage and the renin-angiotensin system in essential hypertension. Study of 63 cases].

Brunner, Laragh et al. have suggested that essential hypertensives with low plasma renin activity (PRA) are at lower risk of myocardial infarction or cerebrovascular accidents than those with high or normal PRA levels. In this paper we report on 63 patients with essential hypertension in whom the relation between PRA and the ocurrence of cardiovascular events was studied. The patients were categorized in high (11%), normal (70%) or low (19%) PRA subgroups, according to their 24-hour sodium excretion. Coronary angiogram was performed in 24 subjects. The three subgroups showed no significant differences in diastolic blood pressure, serum cholesterol levels, smoking habits or obesity. The incidence of cardiovascular complications was similar in patients with high or low PRA levels (28.5% and 33.3% respectively). In those hypertensives in whom coronary angiogram was done, coronary lesions were observed in 80% of the low renin subjects and in 37.5% of those patients with normal PRA. Therefore, no relation between PRA levels and vascular complications was observed in this series of patients. It is conclude that patients with essential hypertension must be treated as soon and effectively as possible regardless of their PRA value.