[Continuous long-term treatment with diuretics of hypertension and the status of the renin-angiotensin-aldosterone system]. / O dlitel'nom nepreryvnom lechenii diuretikami bol'nykh gipertonicheskoi bolezn'iu i sostoianie renin-angiotenzin-al'dosteronovoi sistemy.

One hundred fifty eight patients with essential hypertension (both in- and out-patients) at stages IIA and IIB were treated with diuretics: furosemide (120 mg/day) during three days followed by hydrochlorothiazide in the doses that allow maintaining the renal sodium and water transport of the changed level. Criteria developed for prognosis of the efficiency of diuretic therapy according to the degree of reduction of the mean BP and plasma renin activity after 3-day furosemide intake; indications were worked out for a simultaneous prescription of the potassium-sparing drug amiloride. A good hypotensive effect was noted (reduction of the mean BP by 10 mm Hg) during the first month of treatment in 60 and 70% of in-patients, and in 22 and 40% out-patients with IIB and IIA stages of the disease, respectively. During 6 months of prolonged treatment with diuretics (1-2 years) the sensitivity of the patients to the therapy was increased that permitted the dose of hydrochlorothiazide to be reduced to 25 mg a day or every other day. Patients with good hypotensive effect of therapy were noted to have less pronounced degree of activation of the renin-angiotensin-aldosterone system, than that in patients with ineffective treatment.

[Functional state of the renin-angiotensin system in the diuretic therapy of hypertension]. / Funktsional'noe sostoianie renin-angiotenzinnoi sistemy pri lechenii gipertonicheskoi bolezni diuretikami.

The functional condition of the renin-angiotensin system (RAS) was studied according to the level of plasma-renin activity determined under basal conditions and after walking prior to and after 3 days of medication with furosemide and after a course of hydrochlorothiazide treatment. The authors studied 34 males from 22 to 45 years of age with an uncomplicated course of hypertensive disease and labile or stable hypertension. Three groups of patients were distinguished according to the reaction of renin activity to walking in the control period: I, normorenin with normal basal level of renin activity, a somewhat reduced but within normal ranges and gradually growing during treatment RAS reaction; II, hyperrenin with a higher basal level of renin activity which increased sharply after stimulation by walking and furosemide; III, hyporenin with a very low basal level of renin activity which was areactive to stimulation by walking and hyporeactive to stimulation by furosemide. The hypotensive effect of diuretics was higher in patients of group II. In group III patients there was a prevalent decrease in sytolic arterial pressure. No connection was found between the decrease in arterial pressure and the decrease in the volume of circulating plasma.