[Characteristics of the water-electrolyte metabolism of hypertension patients with stable hypertension and the principles of diuretic therapy]. / Osobennosti vodno-élektrolitnogo obmena u bol'nykh gipertonicheskoi bolezn'iu so stabil'noi gipertenziei i nekotorye printsipy terapii diuretikami.

Different levels of water-salt metabolism control were studied in patients with stable essential hypertension (SEH). The sample was found to be highly heterogeneous in terms of the magnitude of the body's water-filled spaces in relation to plasma renin activity (PRA) and the cooking salt gustatory sensitivity threshold, examined in the presence of various salt diets and diuretic treatments. Three patterns of response to salt loads were identified in SEH patients with respect to sodium and water elimination by the kidneys: the first was identical to that of normal subjects, while the second one featured increased, and the third one, decreased, diuresis and natriuresis. Prostaglandin E2 and kallikrein were shown to be involved in the formation of the second- and third-type renal response to excessive salt. Differential treatment of EH patients with diuretics alone or, where necessary, in combinations with small-dose beta-blockers or vasodilators provides effective BP control for some 1.5 to 2 years in 65% of patients.