Arterial Blood Pressure and the Renin-Angiotensin-Aldosterone System during Postural Changes in Hypertensive Patients with Unilateral Renal Mobility

Abstract

Unilateral renal mobility was identified in 27 out of 100 essential hypertensive patients by examination of renal scintiphotos. The pattern of response to postural changes of blood pressure (BP), plasma renin activity (PRA) and plasma aldosterone concentration (PAC) was investigated in 11 patients with renal mobility and without treatment and compared with that of an age- and sex-matched group of untreated hypertensives without renal mobility. The patients with renal mobility had higher BP levels (X ± SD mm Hg: supine 185 ± 39/112 ± 18 vs. 149 ± 18/97 ± 14; upright 167 ± 38/108 ± 17 vs. 144 ± 7/93 ± 10; p < 0.05). Significant correlations were obtained in the patients with renal mobility (but not in those without renal mobility) between upright PRA and PAC (p < 0.001), their postural variations (p < 0.01) and between upright PRA (and PAC) and BP levels (p < 0.05). The high prevalence of renal mobility in hypertension and the relationship observed between the activated renin-angiotensin-aldosterone system and BP in this condition suggest the importance of searching for unilateral renal mobility when examining the renin-angiotensin-aldosterone system in hypertensive patients, particularly during postural manoeuvres.