Hypertension and Renin Levels

[spj]

So I learned that AA and elderly often have Low renin and so are more senstivie to salt and volume, while non AA and younger people have High Renin.


I am trying to understand the physiology and mechanism of how the low renin can cause hypertension, while having high renin can also cause hypertension.


Thanks for the help!

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[turkeyjerky]

First of all, those are just trends you mentioned, neither are absolute or always present.

So the concept is that some people have an innate (essential) tendency to hold on to salt. These people are labeled 'salt-sensitive' and get hypertensive, by unknown mechanism, due to the sodium and volume retention. This also leads to suppression of renin secretion, thus the low renin levels you mentioned. The low renin is a result, rather than a cause, of the htn.

Other people, more often younger and not black, have an essential hyper secretion of renin. This leads to hypertension as a result of the hyperreninsm. These people will be more amenable to treatment with ACE-inhibitors, as opposed to the other population, who are better treated with diuretics or calcium channel blockers.