The role of renin in hypertension : an old dog with new bite / Johannes Marthinus van Rooyen

Abstract

Foreword: Tigerstedt and Bergman discovered in 1898 the pressure-raising substance from saline rabbit kidney extracts and called the extract renin, however other scientists could not confirm their findings and in 1934, Harry Gold blatt published his results obtained in dog experiments where he clamped one or both renal arteries with a silver clamp. Numerous attempts showed no increases in plasma renin levels in patients with essential hypertension or that renin had any significant physiologic action of its own in humans. Braun-Menendez discovered that renin acted enzymatically on angiotensinogen (plasma protein) to form angiotensin I (inactive) and is further hydrolysed by converting enzyme to form angiotensin II (vasoconstrictor), which increases the blood pressure when it is low. This is the old dog and because renin is not even mentioned in the JNC-VII (US) and the ESH (European) guidelines and when one do a renin profiling on patients/participants and apply the laragh method to individualize the type of hypertension (volume or renin), it is evident that renin plays a large role in the maintenance of normal blood pressure and hypertension. In South African blacks whose hypertension is not under control. this will have a large impact on individualizing specific pathology and treatment and this will give the old dog new bite.