Position Paper: Vasoconstriction and Volume Factors in Renovascular Hypertension

  • Haralambos Gavras
  • Irene Gavras
  • Hans R. Brunner
Conference paper

Abstract

Interest in the pathogenesis of renovascular hypertension has remained strong since Goldblatt’s famous experiment in 1934 where by constricting one renal artery, he produced hypertension that was reversed by clamp removal or nephrectomy. The role of a pressor mechanism via the renin-angiotensin system in this type of hypertension has been vigorously supported and refuted with equally convincing arguments over the years. In support of renin’s contribution to the development and maintenance of renovascular hypertension are the facts that it can be readily produced experimentally by clamping of one renal artery, thus stimulating oversecretion of renin (1); it is frequently characterized by high levels of plasma renin activity (PRA) (2); it can frequently be cured by removal or revascularization of the affected kidney (3); it can be prevented (4) or reversed (5, 6) by administration of various angiotensin inhibitors after the experimental procedure that produces severe stenosis of the renal artery. Against renin’s role are the findings that PRA is sometimes found to be in the normal or even subnormal range (7), and there is no correlation between PRA levels and the degree of hypertension (8); that corrective or ablative surgery is not always successful in curing hypertension (3); that angiotensin blockade does not always produce a fall in blood pressure (5, 9)—in fact, the competitive antagonists of angiotensin II that possess partial agonistic effects may occasionally increase, rather than decrease, the arterial pressure, a reaction characteristic of the low-renin hypertension state attributed to sodium overload (10).

Keywords

Arginine Angiotensin Prostaglandin Norepinephrine Epinephrine 

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Copyright information

© Springer-Verlag New York Inc. 1981

Authors and Affiliations

  • Haralambos Gavras
  • Irene Gavras
  • Hans R. Brunner

There are no affiliations available

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