Summary
The reliability of the angiotensin II (AT II)-antagonist Saralasin in the diagnosis of AT II-dependent forms of hypertension was investigated in 61 cases of hypertension of different etiology. In 14 patients, lowering of blood pressure by Saralasin suggested an AT II-dependent hypertension which could be ascertained in 8 patients (5 had undergone successful surgery) by increased levels of plasma-reninactivity (PRA), AT II, PRA-ratio in renal vein blood and by angiography.
Besides, depressor reactions by Saralasin yielded additional information in three patients with renovascular hypertension but normal levels of PRA and AT II, in two patients with high renin essential hypertension and one patient with pheochromocytoma. This test seems to be valuable in the diagnosis of renin-dependent hypertension.
Zusammenfassung
Der Angiotensin II (AT II)-Antagonist Saralasin wurde an 61 Hypertonikern unterschiedlicher Ätiologie auf Sensibilität und Treffsicherheit in der Diagnostik AT II-abhängiger Hypertonieformen getestet. Blutdrucksenkung unter AT II-Blokkade war bei 14 der untersuchten Patienten Hinweis auf eine AT II-abhängige Hypertonie, die bei 8 Kranken mit reno-vaskulärer Hypertonie — 5 sind bereits erfolgreich operiert — durch erhöhte Plasma-Renin-Aktivität (PRA), AT II, PRA-Gradienten im Nierenvenenblut und Nierenangiographie gesichert werden konnte. Ferner erbrachten Depressor-Reaktionen unter Saralasin bei 3 Patienten mit reno-vaskulärer Hypertonie, jedoch normaler PRA und AT II, bei 2 essentiellen Hypertonikern mit hoher PRA und einer Patientin mit Phäochromocytom wertvolle diagnostische Zusatzinformationen.
Der Test sollte in der Hypertoniediagnostik zum Ausschluß reno-vaskulärer Hypertonien bei Patienten im operationsfähigen Alter und Zustand mit Hochdruck unklarer Genese (diastolischer Blutdruck über 110 mm Hg) als Suchtest AT II-abhängiger Hypertonieformen eingeführt werden.
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Röckel, A., Wernze, H., Sabel, B. et al. Kritische Analyse des Saralasintestes in der Differentialdiagnostik der Hypertonie. Klin Wochenschr 55, 651–656 (1977). https://doi.org/10.1007/BF01482536
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DOI: https://doi.org/10.1007/BF01482536