Vasopressor and Vasodepressor Hormone-Systems in Adolescent Hypertension

We investigated the activity of the renin-angiotensin-aldosterone-system, the secretion of catecholamines and the kallikrein-kinin-system in 126 adolescents randomly selected from a large study of 1342 young people examined in an epidemiological survey conducted in Cologne in 1975, 1976 and 1980. 73 of them with arterial blood pressures below 145/90 mm Hg were called "normotensives" (systolic blood pressure 127.2 ± 1.0 mm Hg, diastolic bp 79.7 ± 0.8 mm Hg). They were compared with 53 "hypertensives" (systolic blood pressure 147.2 ± 1.6 mm Hg, diastolic bp 93.7 ± 1.1 mm Hg). Urinary catecholamines were significantly higher in the hypertensives (155.0 ± 13.3 μg/d) compared to the normotensives (100.7 ± 5.3 μg/d) (p < 0.001) whereas plasma levels of adrenaline and noradrenaline were similar. Serum aldosterone levels and plasmarenin-concentrations were not different between the two groups. Angiotensin-converting-enzyme-activity was slightly higher in the hypertensive group (107.1 ± 3.5 U/1 versus 98.0 ± 2.6 U/1, p < 0.001). Urinary kallikrein excretion was found to be modestly lower in hypertensives compared to normotensives (0.40 ± 0.05 versus 0.55 ± 0.06 mU/mg creatinine). Urinary excretion of sodium and potassium, blood levels of glucose, uric acid, cholesterol and triglycerides were similar in both groups. The results of the present study suggest an increased sympathetic activity in the early stage of hypertension in adolescents.