In the first part the pathogenetic factors of the various edematous diseases are discussed, especially the pathogenesis of cardiac, hepatic, renal and idiopathic edemas. In the second part the therapy of edematous diseases is discussed, especially the effects, side effects, indications and contraindications of diuretics and mineralocorticoid antagonists.

Antihypertensive Agents↗

PubMed1977

[Pathogenesis and therapy of edematous diseases. 1. Pathogenesis of edematous diseases].

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Aldosterone↗

PubMed1976

[The effects of calcitonin, glucagon and the dibutyryl derivative of cyclic AMP on plasma-renin activity (author's transl)].

Infusion of 2 MRC/kg X h calcitonin in anaesthetised dogs produced a significant increase in plasma-renin activity, clearance of 51Dr-EDTA and 125I-o-iodohipuric acid, heart rate and urinary excretion of sodium, potassium, calcium and phosphates, while serum electrolytes and mean arterial pressure markedly fell. Infusion of 5 mug/kg X min glucagon produced a significant fall of plasma-renin, heart rate rose, but arterial mean pressure fell, and serum and urinary electrolytes did not change significantly, Cyclic AMP (dibutyryl-cAMP) significantly stimulated renin at a dose of 5 mg/min, while there were no significant changes in blood pressure, heart rate and serum and urinary electrolytes.

Animals↗

PubMed1976

The effect of minoxidil on blood pressure and plasma renin activity in patients with essential and renal hypertension.

The effect of the new vasodilator, minoxidil, on blood pressure and plasma renin activity was studied in 21 hypertensive patients: 12 patients with essential and 9 with renal hypertension. The average maximum dosage of minoxidil was 27.9 +/- 6.0 mg/day (M +/- SD). Average duration of treatment was 84.5 days. During the observation period the average systolic blood pressure fell from 195 +/- 18 to 159 +/- 7 mm Hg (M +/- SD), and the mean diastolic blood pressure fell from 120 +/- 8.3 to 92.5 +/- 8 mm Hg (p less than 0.01). These patients had been treated earlier with other antihypertensive agents, such as reserpine, saluretics, hydralazine, alpha-methyldopa, and clonidine, without any significant reduction in blood pressure. Before treatment, plasma renin activity after resting was 59 +/- 6.4 ng/ml/16 h (M +/- SE) and after saluretics and orthostasis 89 +/- 12.7 ng/ml/16 h. After treatment, the decline in renin value after resting was statistically significant: 42.7 +/- 3.3 ng/ml/16 h (p less than 0.05), and the stimulated renin had fallen to 70 +/- 3.4 ng/ml/16 h (p greater than 0.1). A comparison of the renin stimulation values of patients with renal hypertension also revealed a significant reduction (p less than 0.01). Side effects which appeared at a daily dose of 15 to 30 mg consisted mainly of tachycardia and fluid retention and could be controlled by the administration of propranolol and chlorthalidone. In 5 women and in 1 man was observed a cosmetically disturbing, reversible hypertrichosis. Orthostatic hypotension was observed in one patient. Minoxidil is an effective antihypertensive agent. However, because of its side effects, it generally must be administered with beta-receptor blocking agents and saluretics. It is possible that its blood pressure lowering effect is due, at least in part, to a suppression of the plasma renin activity.

Adult↗

PubMed1976

[Effect of pindolol (Visken) on blood pressure and plasma renin activity in various forms of hypertension].

1. In 20 of 20 patients (100%) with borderline hypertension Visken normalized the labile blood pressure. The high renin values after stimulation due to orthostasis and saluresis decreased significantly (p less than 0,01). 2. In 3 of 12 patients (25%) with hyporeninemic essential hypertension Visken alone normalized the blood pressure. The low renin values increased to the normal range. 3. In 4 of 18 patients (22%) with normoreninemic essential hypertension Visken normalized the blood pressure. The normal renin values showed a decreasing tendency within the normal range. 4. In 4 of 10 patients (40%) with hyperreninemic essential hypertension Visken normalized the high blood pressure. In 3 of these patients renin decreased distinctly. 5. In 4 of 20 patients (20%) with renal hypertension a therapy with Visken alone normalized the blood pressure. In 3 patients the high renin values decreased to the normal range. 6. In the most other patients of the groups II to V the additional therapy with diuretics and reserpine normalized the blood pressure. In these cases the renin values showed different reactions corresponding to the different effects of betablocking agents, saluretics or reserpine on the plasma renin activity [7]. 7. It is interesting, that Visken not only suppresses high renin values (borderline hypertension [6], hyperreninemic essential hypertension), but also increases low renin values to the normal range in patients with hyporeninemic essential hypertension. Because in essential hypertension the high blood pressure per se may be responsible for the renin suppression [3,4], this increase of renin activity is possibly the consequence of blood pressure reduction, while the decrease of renin activity after Visken may be the cause of blood pressure reduction.

Adult↗

PubMed1976