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(Hypertension. 2000;35:952.)
© 2000 American Heart Association, Inc.

Scientific Contributions

Glomerular Hyperfiltration, High Renin, and Low- Extracellular Volume in High Blood Pressure

Stephen B. Harrap; Allan D. Cumming; David L. Davies; Christopher J. W. Foy; Robert Fraser; Atsushi Kamitani; J. Michael Connor; Anthony F. Lever; Graham C. M. Watt

From the Department of Physiology (S.B.H., A.K.), The University of Melbourne, Parkville, Victoria, Australia; the MRC Blood Pressure Unit (R.F., A.F.L.) and the Department of Medicine & Therapeutics (D.L.D.), Western Infirmary, Glasgow, UK; the Department of Medicine (A.D.C.), Royal Infirmary, Edinburgh, UK; the Northern Regional Health Authority (C.J.W.F.), Newcastle upon Tyne, UK; Duncan Guthrie Institute of Medical Genetics (J.M.C.), Yorkhill, Glasgow, UK; and the Department of Public Health (G.C.M.W.), University of Glasgow, Glasgow, UK.

Abstract—Abnormal renovascular resistance and glomerular filtration rate are characteristic of established hypertension and may also be involved in its pathogenesis. To determine renal and body fluid correlates of the predisposition to high blood pressure, we examined 100 healthy young adults with high or low blood pressure. Within each group, half had parents with high blood pressures, and half had parents with low blood pressures. Renal function and hemodynamics, body fluid volumes, and relevant hormones and genotypes were measured. Subjects with high personal and parental blood pressures had the highest levels of glomerular filtration rate (P<0.02) and plasma active renin concentration and low levels of exchangeable sodium and plasma volume (P<0.02). High glomerular filtration rate was not associated with differences in urinary kallikrein or prostaglandins. Polymorphisms of the renin, angiotensin-converting enzyme, and angiotensinogen genes were not associated with differences in glomerular filtration rate or renin. Subjects with high personal, but low parental, blood pressures had low exchangeable sodium and plasma volumes (P<0.02) but normal glomerular filtration rates. In this population, extracellular volume depletion and high renin are correlates of high blood pressure in early adulthood, and glomerular hyperfiltration is a feature of those who also have familial predisposition to high blood pressure.

Key Words: electrolytes • family history • genetics • renal function • renin