[Renin-angiotensin-aldosterone system in hypertension patients who have had a cerebral stroke]. / Sostoianie renin-angiotenzin-al'dosteronovoi sistemy u bol'nykh gipertonicheskoi bolezn'iu, perenesshikh mozgovoi insul't.

The study of the renin activity and aldosterone concentrations in the blood plasma has revealed activation of the renin-angiotensin-aldosterone system (RAAS) in patients with stage III essential hypertension and a history of 1-3-year-old cerebral stroke. Middle-aged patients demonstrated high activity of renin and high levels of aldosterone whereas elderly patients presented a moderate rise in renin activity and elevated aldosterone levels. The data obtained indicate a decrease in the endocrine function of the kidneys in elderly hypertensive patients with a history of cerebral stroke. The authors revealed a considerable hypersecretion of aldosterone in the presence of a moderate elevation of plasma renin activity in patients with the cerebral form of stage II essential hypertension at the height of the crisis. It is suggested that aldosterone hypersecretion in elderly patients with stage III essential hypertension and residual manifestations of cerebral circulation impairment is pathogenetically important.

[Changes in reactivity of the renin-angiotensin-aldosterone system in old age as a risk factor in the development of hypertension]. / Izmenenie reaktivnosti renin-angiotenzin-al'dosteronovoi sistemy v statosti kak faktor riska razvitiia gipertonicheskoi bolezni.

The sensitivity of the renin-angiotensin-aldosterone system (RAAS) to regulatory sympathoadrenal and hypothalamo-pituitary effects was shown to increase with advancing age, in spite of declining plasma renin and aldosterone baselines. At the same time, this humoral mechanism was no longer capable of responding as adequately to potent stimuli, such as submaximum physical stress. The data obtained suggest that the RASS might act as a trigger mechanism underlying a greater incidence of essential hypertension in old age.

The state of the renin-angiotensin-aldosterone system in various clinical forms of hypertension in aging.

The authors' data give evidence for an early involvement of the renin-angiotensin-aldosterone system in the hypertension pathogenesis with aging. The elderly patients with the systolic hypertension variant showed marked hyporeninemia and hyperaldosteronemia, while those with the systolic-diastolic variant displayed an increased or normal plasma renin activity against moderately increased aldosterone concentration. There was a marked increase of plasma renin activity in the patients with the cardiac form and a high circulating aldosterone concentration with the cerebral form of hypertension. The results suggest a certain interrelationship between the clinical picture of the disease and the renin-angiotensin-aldosterone system. The latter must be taken into consideration when making decisions regarding therapy and prophylaxis of hypertension.