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Plasma Renin Determination

Louis C. Johnston, MD
JAMA. 1975;232(2):135. doi:10.1001/jama.1975.03250020013009.
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To the Editor.—  I enjoyed the timely note of Victor Vertes that helpfully summarized the current clinical status of plasma renin determinations (230:1279, 1974). I believe a few clarifying or precautionary comments are in order. Minoxidil does not inhibit renin, but stimulates its release.1While renin assay has epochally expanded our understanding of hypertensive pathophysiology, its use as a risk marker of premature arteriopathy in human hypertension has been very seriously questioned and is unconfirmed by most recent studies.2 A cautious and carefully controlled study,3 based on earlier animal experimentation relating the triad of hyperreninism, hyperaldosteronism, and hypertension to unique severe angiopathy, led to nine clinical subgroupings based on renin vs aldosterone: high, low, or normal, and each with varying amounts of serious vascular disease. Any grouping, however, purporting a specific that is importantly related to hypertensive morbidity but found in a smaller percentage of blacks than


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