IN THE management of a hypertensive patient, the physician is faced with the primary question of what the most effective way to lower the blood pressure is, since blood pressure reduction has been shown to be the key to prevention of the major cardiovascular complications of hypertension.1,2 More specifically, one must decide whether the hypertensive disorder is potentially curable by surgical intervention, or if not, what minimal antihypertensive drug regimen may succeed in normalizing the blood pressure. The aim of this discussion is to outline briefly how the measurement of plasma renin levels, or quantitation of the renin-angiotensin pressor effect, can be of value in the treatment of essential hypertension and in the diagnosis of surgically curable hypertension.
Before reviewing the role of the renin-angiotensin system in clinical hypertension, it is necessary to understand the close physiologic link that exists between this hormonal system and body sodium and water