Plasma renin activity in renovascular hypertension

Plasma renin activity was measured in forty-eight hypertensive patients with angiographie evidence of unilateral or bilateral occlusive disease of a main stem renal artery. Increased plasma renin activity in patients with unilateral renal arterial lesions was almost always (96 per cent) predictive of a satisfactory response to subsequent and technically successful surgery. In contrast, when plasma renin activity was normal, technically successful surgical intervention was not associated with a postoperative reduction of blood pressure. These data demonstrate that measurements of plasma renin activity in hypertensive patients with unilateral renal arterial disease provide an excellent guide to the success or failure of subsequent surgical therapy. Further studies are required to determine whether measurements of plasma renin activity are similarly useful in hypertensive patients with bilateral renal arterial lesions.