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Ann Thorac Surg 1987;43:74-77
© 1987 The Society of Thoracic Surgeons

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Articles

The Renin-Angiotensin System Is Not Responsible for Hypertension Following Coronary Artery Bypass Grafting

From the Division of Cardiovascular Surgery, Department of Surgery, the Division of Nephrology, Department of Medicine, the Department of Anesthesia, and the Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, NY

Accepted for publication February 10, 1986.

^* Address reprint requests to Dr. Weinstein, 130 East 77th St, New York, NY 10021

Systemic hypertension following coronary artery bypass graft (CABG) procedures has been reported to occur in 15% to 80% of cases. Previous reports have implicated the renin-angiotensin system as being responsible, at least in part, for this phenomenon. In this prospective study, 18 previously normotensive subjects were studied before, during, and after CABG. In 4 patients (22%), paroxysmal postoperative hypertension developed (systolic blood pressure > 150 mm Hg). There were no differences between the normotensive and hypertensive groups in plasma renin activity, angiotensin II level, or aldosterone level. Despite the trend toward elevation of these variables during cardiopulmonary bypass (CPB), all had returned to control levels within two hours after CPB, whether or not hypertension developed. Serum norepinephrine levels were elevated (.10 > p > .05) in the hypertensive group at the time hypertension developed. No other relationship or pattern could be defined to distinguish the hypertensive from the normotensive group. The renin-angiotensin system does not appear to be responsible for paroxysmal hypertension following CABG.

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