FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 324:1305-1311 May 9, 1991 Number 19 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

BACKGROUND AND METHODS. The kidney is important in blood-pressure regulation, but its role in the development of essential hypertension is still subject to debate. We compared renal hemodynamics, measured in terms of the clearance of para-aminohippuric acid and inulin, and the characteristics of the renin-angiotensin-aldosterone system in three groups of normotensive subjects at different degrees of risk for hypertension: 41 subjects with two normotensive parents, 52 with one normotensive and one hypertensive parent, and 61 with two hypertensive parents. The subjects ranged in age from 7 to 32 years. RESULTS. The mean renal blood flow was lower in the subjects with two hypertensive parents than in those with two normotensive parents (mean difference [+/- SE], 198 +/- 61 ml per minute per 1.73 m2 of body-surface area; P = 0.002). Moreover, both the filtration fraction and renal vascular resistance were higher in the subjects with two hypertensive parents (filtration fraction: mean difference, 3.0 +/- 1.1 percentage points; P = 0.006; renal vascular resistance: mean difference, 2.7 +/- 0.8 mm Hg per deciliter per minute per 1.73 m2; P = 0.006). The subjects with two hypertensive parents had lower plasma concentrations of renin (mean difference, 3.3 +/- 1.6 mU per liter; P = 0.03) and aldosterone (mean difference, 111 +/- 36 pmol per liter; P = 0.003) than those with two normotensive parents. The differences could not be explained by the small differences in blood pressure between the groups. The values in the subjects with one hypertensive and one normotensive parent fell between those for the other two groups. CONCLUSIONS. Renal vasoconstriction is increased and renin and aldosterone secretion is decreased in young persons at risk for hypertension. These findings support the hypothesis that alterations in renal hemodynamics occur at an early stage in the development of familial hypertension.

Source Information

Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.

This article has been cited by other articles:

• Lieb, W., Pencina, M. J., Wang, T. J., Larson, M. G., Lanier, K. J., Benjamin, E. J., Levy, D., Tofler, G. H., Meigs, J. B., Newton-Cheh, C., Vasan, R. S. (2008). Association of Parental Hypertension With Concentrations of Select Biomarkers in Nonhypertensive Offspring. Hypertension 52: 381-386 [Abstract] [Full Text]  
• Skov, K., Eiskjaer, H., Hansen, H. E., Madsen, J. K., Kvist, S., Mulvany, M. J. (2007). Treatment of Young Subjects at High Familial Risk of Future Hypertension With an Angiotensin-Receptor Blocker. Hypertension 50: 89-95 [Abstract] [Full Text]  
• Skov, K., Madsen, J. K., Hansen, H. E., Zagato, L., Frandsen, E., Bianchi, G., Mulvany, M. J. (2006). Renal Haemodynamics are not Related to Genotypes in Offspring of Parents with Essential Hypertension. Journal of Renin-Angiotensin-Aldosterone System 7: 47-55 [Abstract]  
• Bianchi, G. (2005). Genetic variations of tubular sodium reabsorption leading to "primary" hypertension: from gene polymorphism to clinical symptoms. Am. J. Physiol. Regul. Integr. Comp. Physiol. 289: R1536-R1549 [Abstract] [Full Text]  
• Fesler, P., du Cailar, G., Ribstein, J., Mimran, A. (2004). Heterogeneity of Cardiorenal Characteristics in Normotensive Subjects. Hypertension 43: 219-223 [Abstract] [Full Text]  
• Kosachunhanun, N., Hunt, S. C., Hopkins, P. N., Williams, R. R., Jeunemaitre, X., Corvol, P., Ferri, C., Mortensen, R. M., Hollenberg, N. K., Williams, G. H. (2003). Genetic Determinants of Nonmodulating Hypertension. Hypertension 42: 901-908 [Abstract] [Full Text]  
• Reddi, A. S., Nimmagadda, V. R., Arora, R. (2001). Effect of Antihypertensive Therapy on Renal Artery Structure in Type 2 Diabetic Rats With Hypertension. Hypertension 37: 1273-1278 [Abstract] [Full Text]  
• Skov, K., Mogensen, S., Mulvany, M. J (2001). Persistent effect of treatment with candesartan cilexetil on blood pressure in spontaneously hypertensive rats. Journal of Renin-Angiotensin-Aldosterone System 2: S91-S94 [Abstract]  
• Kotchen, T. A., Kotchen, J. M., Grim, C. E., George, V., Kaldunski, M. L., Cowley, A. W., Hamet, P., Chelius, T. H. (2000). Genetic Determinants of Hypertension : Identification of Candidate Phenotypes. Hypertension 36: 7-13 [Abstract] [Full Text]  
• Harrap, S. B., Cumming, A. D., Davies, D. L., Foy, C. J. W., Fraser, R., Kamitani, A., Connor, J. M., Lever, A. F., Watt, G. C. M. (2000). Glomerular Hyperfiltration, High Renin, and Low- Extracellular Volume in High Blood Pressure. Hypertension 35: 952-957 [Abstract] [Full Text]  
• Lopes, H. F., Silva, H. B., Soares, J. A., Filho, B., Consolim-Colombo, F. M., Giorgi, D. M. A., Krieger, E. M. (1997). Lipid Metabolism Alterations in Normotensive Subjects With Positive Family History of Hypertension. Hypertension 30: 629-631 [Abstract] [Full Text]  
• Geleijnse, J. M., Hofman, A., Witteman, J. C. M., Hazebroek, A. A. J. M., Valkenburg, H. A., Grobbee, D. E. (1997). Long-term Effects of Neonatal Sodium Restriction on Blood Pressure. Hypertension 29: 913-917 [Abstract] [Full Text]  
• Skov, K., Fenger-Gron, J., Mulvany, M. J. (1996). Effects of an Angiotensin-Converting Enzyme Inhibitor, a Calcium Antagonist, and an Endothelin Receptor Antagonist on Renal Afferent Arteriolar Structure. Hypertension 28: 464-471 [Abstract] [Full Text]  
• van Paassen, P., de Zeeuw, D., Navis, G., de Jong, P. E. (1996). Does the Renin-Angiotensin System Determine the Renal and Systemic Hemodynamic Response to Sodium in Patients With Essential Hypertension?. Hypertension 27: 202-208 [Abstract] [Full Text]  
• Grunfeld, B., Gimenez, M., Balzaretti, M., Rabinovich, L., Romo, M., Simsolo, R. (1995). Insulin Effect on Renal Sodium Reabsorption in Adolescent Offspring of Essential Hypertensive Parents. Hypertension 26: 1089-1092 [Abstract] [Full Text]  
• Kaasjager, K. A. H., Koomans, H. A., Rabelink, T. J. (1995). Effectiveness of Enalapril Versus Nifedipine to Antagonize Blood Pressure and the Renal Response to Endothelin in Humans. Hypertension 25: 620-625 [Abstract] [Full Text]  
• Puig, J. G., Miranda, M. E., Mateos, F. A., Picazo, M. L., Jimenez, M. L., Calvin, T. S., Gil, A. A. (1993). Hereditary Nephropathy Associated With Hyperuricemia and Gout. Arch Intern Med 153: 357-365 [Abstract]