Oral Contraceptives: Renin, Aldosterone, and High Blood Pressure

A relationship was established between the institution of oral contraceptive therapy and the development or enhancement of high blood pressure in eight of 11 patients. In six of eight patients who stopped taking medication, marked improvement or complete correction of hypertension occurred. In two patients, with a second trial of treatment, hypertension again appeared and disappeared. Oral contraceptive therapy produced impressive abnormalities in renin-substrate concentration and in its reactivity to exogenous renin as well as in endogenous renin activity and aldosterone excretion. The relevance of these abnormalities to the development of hypertension is not clear because similar effects occur in treated normotensive women. Further study of a possible connection between excesses of estrogenic and progestogenic substances, renin, aldosterone, and hypertension seems warranted.