Impaired renal production of prostaglandin E2: a newly identified lesion in human essential hypertension.

To test the hypothesis that impaired renal prostaglandin production may accompany the hypertensive state, we have measured urinary PGE2 by radioimmunoassay in 52 normotensive and 50 hypertensive subjects. PGE2 levels were lower in females, and were not affected by Na+ intake or age. Patients with essential hypertension had significantly lower PGE2, particularly those with low-renin hypertension. Forty percent of the hypertensives excreted less than 70 ng/24 hr, values never observed in normotensives except after receiving indomethacin, a well-known prostaglandin synthetase inhibitor. It appears that impaired renal prostaglandin production is commonly encountered in patients with essential hypertension, perhaps contributing to their increased renal resistance. The data further suggest a role for renal prostaglandins in the pathogenesis of low-renin hypertension.