Effect of sodium depletion on plasma renin concentration before and during adrenergic β-receptor blockade with propranolol in normotensive man

      This paper is only available as a PDF. To read, Please Download here.


      Plasma renin levels have been used to discriminate between different forms of hypertension, but how to define the normal range of plasma renin levels has not been agreed upon. Sodium depletion stimulates renin release. Evaluation of plasma renin would, therefore, seem possible only in relation to sodium balance.
      Plasma renin concentration and concurrent daily sodium excretion were determined in 33 healthy normotensive subjects (control group) ingesting high, normal and low sodium diets. A well-defined hyperbolic relationship was found between the two variables indicating that the physiologic level of plasma renin concentration depends on the state of sodium balance. An increase in plasma potassium concentration may reduce plasma renin concentration, but this appeared to be overruled by the stimulating effect of sodium depletion.
      To examine whether β-adrenergic stimulation contributes to the increase in plasma renin concentration during sodium depletion, the relationship between plasma renin concentration and concurrent sodium excretion was studied during β-receptor blockade with propranolol. In 20 healthy normotensive subjects in whom β-receptor blockade was verified by a significant reduction in pulse rate, the same hyperbolic relationship was found between plasma renin concentration and sodium excretion as in the control group showing that sodium depletion stimulates renin release independent of sympathetic nervous activity.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Peart WS
        The renin-angiotensin system.
        Pharmacol Rev. 1965; 17: 143
        • Brubacher ES
        • Vander AJ
        Sodium deprivation and renin secretion in unanesthetized dogs.
        Am J Physiol. 1968; 214: 15
        • Brown JJ
        • Davies DL
        • Lever AF
        • et al.
        Influence of sodium loading and sodium depletion on plasma-renin in man.
        Lancet. 1963; 2: 278
        • Laragh JH
        • Sealey JE
        • Sommers SC
        Patterns of adrenal secretion and urinary excretion of aldosterone and plasma renin activity in normal and hypertensive subjects.
        Circ Res. 1966; 18–19: 158
        • Gunnells JC
        • Grim CE
        • Robinson RR
        • et al.
        Plasma renin activity in healthy subjects and patients with hypertension.
        Arch Intern Med. 1967; 119: 232
        • Laragh JH
        • Baer L
        • Brunner HR
        • et al.
        Renin, angiotensin and aldosterone system in pathogenesis and management of hypertensive vascular disease.
        Am J Med. 1972; 52: 633
        • Doyle AE
        • Chua KG
        • Duffy S
        • et al.
        Plasma renin, urinary sodium excretion and vascular disease.
        Clin Sci Molec Med. 1975; 48: 127s
        • Davies DL
        • Schalekamp MA
        • Beevers DG
        • et al.
        Abnormal relations between exchangeable sodium and the reninangiotensin system in malignant hypertension and in hypertension with chronic renal failure.
        Lancet. 1973; 1: 683
        • Vander AJ
        Effect of catecholamines and the renal nerves on renin secretion in anesthetized dogs.
        Am J Physiol. 1965; 209: 659
        • Davis JO
        The control of renin release.
        Am J Med. 1973; 55: 333
        • Eide I
        • Løyning E
        • Kiil F
        Evidence for hemodynamic autoregulation of renin release.
        Circ Res. 1973; 32: 237
        • Ayers CR
        • Harris RH
        • Lefer LG
        Control of renin release in experimental hypertension.
        Circ Res. 1969; 24 (suppl): 103
        • Gottschall RW
        • Davis JO
        • Blaine EH
        • et al.
        Increased renin release during renal arteriolar dilatation in dogs.
        Am J Physiol. 1974; 227: 251
        • Vander AJ
        • Miller R
        Control of renin secretion in the anesthetized dog.
        Am J Physiol. 1964; 207: 537
        • Vander AJ
        • Luciano JR
        Neural and humoral control of renin release in salt depletion.
        Circ Res. 1967; 20–21: 69
        • Mogil RA
        • Itskovitz HD
        • Russell JH
        • et al.
        Renal innervation and renin activity in salt metabolism and hypertension.
        Am J Physiol. 1969; 216: 693
        • Haber E
        • Koerner T
        • Page LB
        • et al.
        Application of a radioimmunoassay for angiotensin I to the physiologic measurements of plasma renin activity in normal human subjects.
        J Clin Endocrinol Metab. 1969; 29: 1349
        • Haas E
        • Gould AB
        • Goldblatt H
        Estimation of endogenous renin in human blood.
        Lancet. 1968; 1: 657
        • Snedecor GW
        • Cochran WG
        Statistical Methods.
        6th ed. State University Press, Iowa1967
        • Howell DS
        • Davis JO
        Relationship of sodium retention to potassium excretion by the kidney during administration of desoxycorticosterone acetate to dogs.
        Am J Physiol. 1954; 179: 359
        • Anderson HM
        • Laragh JH
        Renal excretion of potassium in normal and sodium depleted dogs.
        J Clin Invest. 1958; 37: 323
        • Brunner HR
        • Baer L
        • Sealey JE
        • et al.
        The influence of potassium loading and potassium deprivation on plasma renin in normal and hypertensive subjects.
        J Clin Invest. 1970; 49: 2128
        • Vander AJ
        Direct effects of potassium on renin secretion and renal function.
        Am J Physiol. 1970; 219: 455
        • Himathongkam T
        • Dluhy RG
        • Williams GH
        Potassium-aldosterone-renin interrelationships.
        J Clin Endocrinol Metab. 1975; 41: 153
        • Vander AJ
        Control of renin release.
        Physiol Rev. 1967; 47: 359
        • Johnson JA
        • Davis JO
        • Baumber JS
        • et al.
        Effects of hemorrhage and chronic sodium depletion on hepatic clearance of renin.
        Am J Physiol. 1971; 220: 1677
        • Geyskes GG
        • Boer P
        • Leenen FHH
        • et al.
        Effect of volume depletion and subsequent propranolol treatment on blood pressure and plasma renin activity in patients with essential and with renovascular hypertension.
        Clin Sci Molec Med. 1975; 48: 69s
        • Weber MA
        • Kleerekoper M
        • Thornell IR
        • et al.
        Effects of sodium depletion on plasma renin activity and on the urinary excretion of cyclic AMP and aldosterone in hypoparathyroid patients.
        J Clin Endocrinol Metab. 1975; 40: 982
        • Bravo EL
        • Tarazi RC
        • Dustan HP
        On the mechanism of suppressed plasma-renin activity during β-adrenergic blockade with propranolol.
        J Lab Clin Med. 1974; 83: 119
        • Attman PO
        • Aurell M
        • Johnsson G
        Effects of metoprolol and propranolol on furosemide-stimulated renin release in healthy subjects.
        Europ J Clin Pharmacol. 1975; 8: 201
        • Eide I
        • Løyning E
        • Langaard Ø
        • et al.
        Influence of ethacrynic acid on intrarenal renin release mechanisms.
        Kidney Int. 1975; 8: 158
        • Michelakis AM
        • McAllister RG
        The effect of chronic adrenergic receptor blockade on plasma renin activity in man.
        J Clin Endocrinol. 1972; 34: 386
        • Bravo EL
        • Tarazi RC
        • Dustan HP
        • et al.
        Dissociation between renin and arterial pressure responses to β-adrenergic blockade in human essential hypertension.
        Circ Res. 1975; 36–37: 241
        • La Grange RG
        • Sloop CH
        • Schmid HE
        Selective stimulation of renal nerves in the anesthetized dog. Effect on renin release during controlled changes in renal hemodynamics.
        Circ Res. 1973; 33: 704
        • Eide I
        • Løyning E
        • Kiil F
        Potentiation of renin release by combining renal arterial constriction and β-adrenergic stimulation.
        Scand J Clin Lab Invest. 1974; 34: 301
        • Bühler FR
        • Laragh JH
        • Vaughan Jr, ED
        • et al.
        Antihypertensive action of propranolol. Specific antirenin responses in high and normal renin forms of essential, renin, renovascular and malignant hypertension.
        Am J Cardiol. 1973; 32: 511