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The Effect of Conjugated Estrogens on the Renin-Angiotensin System

Division of Hypertensive Studies, Department of Internal Medicine, and Department of Physiology, Wayne State University Medical School, Section of Endocrinology, Hutzel Hospital Medical Unit, Detroit, Michigan 48201, and the Stanford Heart Disease Prevention Program, Stanford University School of Medicine Stanford, California 94305

Reprint requests to: Charles P. Lucas, M. D., Hutzel Hospital, 4707 St. Antoine, Detroit, Michigan 48201.

In a survey of 3 California communities by the Stanford Heart Disease Prevention Program, we obtained data on blood pressure, medications, age, height and weight, blood for measurement of plasma renin activity (PRA), plasma renin concentration (PRC), plasma renin reactivity (RR), and plasma renin substrate concentration (PRS), and urine for measurement of urinary sodium and creatinine. No effect of conjugated estrogens (Premarin®) on blood pressure could be discerned when the blood pressure, corrected for age and relative weight, of 575 women on no medication was compared to that of 82 women taking only Premarin. Premarin increased PRA, PRS, and RR, but had no effect on PRC. We also found in both Premarin-treated women and controls 1) that RR was positively correlated with PRS, and 2) that PRA is dependent on PRC and PRS. These data indicate that the reninrenin substrate reaction of plasma, even at normal substrate concentration, is strongly dependent on PRS.

Supported in part by a grant from the Michigan Heart Association, from the Research and Education Fund of Hutzel Hospital, and NIH Research GrantNo. 14174 from the National Heart and Lung Institute.

Received May 6, 1976.

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