Letter by Zhou and Zhou Regarding Article, “Hypertension: Renin–Angiotensin–Aldosterone System Alterations”
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To the Editor:
Activation of the renin–angiotensin–aldosterone system (RAAS) is believed to play an important role in hypertension. However, although having a higher risk of hypertension,1 blacks exhibit lower plasma renin levels compared with whites.2 Moreover, black hypertensives show an accentuated responses to diuretics but blunted responses to angiotensin-converting enzyme inhibitors as monotherapy.3 How RAAS activity is altered in hypertension is still not completely understood.
Recently, Te Riet et al4 reviewed RAAS alterations in hypertension and emphasized the role of tissue angiotensin in hypertension. In their review, they have not considered the possibility that the RAAS alterations may be secondary to excretory …