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Effect of Oral Contraceptive Therapy on the Renin-Angiotensin System in Normotensive and Hypertensive Women

From the Department of Internal Medicine and of Obstetrics and Gynecology Mayo Clinic and Mayo Foundation, Rochester, Minnesota

Abstract

Plasma renin activity, plasma renin substrate, angiotensin I, and plasma angiotensinase activity were measured in 13 women, of whom 5 were normotensive during oral contraceptive therapy (OCT) and 8 became hypertensive during such therapy. In one 21-day cycle of OCT. the mean plasma renin activity increased by two-thirds and the plasma renin substrate more than doubled in both groups of women. The mean angiotensin I increased in both groups— by about two-thirds in the normotensives, and by not quite one-half in the hypertensives. The mean plasma angiotensinase activity increased by one-half among the normotensives; in contrast, it decreased slightly among the hypertensives, only 2 of whom showed increases. Our findings agree with the hypothesis that abnormal inactivation of angiotensin II may have an important influence on the pathogenesis of arterial hypertension complicating oral contraceptive therapy.