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Evaluation of plasma renin activity by blood pressure level (pressure-renin index) in patients with essential hypertension.

Under various conditions of sodium balance, 1-sarcosine-8-isoleucine angiotensin II was infused into 15 normotensive controls and 82 patients with benign essential hypertension. Changes in mean blood pressure induced by the analogue were correlated with the logarithm of plasma renin activity (r = -0.763, p less than 0.001 for the controls; r = -0.776, p less than 0.001 for the patients). Although the coefficients of determination were much the same, 0.95 confidence limits of the regression line did not overlap at renin levels over 7 ng/ml/h. At those levels, a decrease in the mean blood pressure induced by the analogue was greater in the hypertensive patients. A pressure-renin index was defined as a product of the logarithm of plasma renin activity and the mean blood pressure measured before the analogue infusion. The correlation between the analogue effect and the pressure-renin index was highly significant (r = -0.763, p less than 0.001 for the controls; r = -0.777, p less than 0.001 for the hypertensive patients). The regression line (0.95 confidence limit) for the hypertensives coincided with that for the normotensives. Thus, the blood pressure level should be taken into account when attempting to evaluate plasma renin activity.