The pathophysiological mechanisms responsible for maintenance of chronic re
novascular hypertension remain undefined, Excess angiotensin II generation
may lead to release of reactive oxygen species and increased vasoconstricto
r activity. To examine the potential involvement of oxidation-sensitive mec
hanisms in the pathophysiology of renovascular hypertension, blood samples
were collected and renal blood flow measured with electron-beam computed to
mography in pigs 5 and 10 weeks after induction of unilateral renal artery
stenosis (n=7) or sham operation (n=7). Five weeks after procedure, plasma
renin activity and mean arterial pressure were elevated in hypertensive pig
s. Levels of prostaglandin F2 alpha (PGF2 alpha)-isoprostanes, vasoconstric
tors and markers of oxidative stress, also were significantly increased (15
7+/-21 versus 99+/-16 pg/mL; P<0.05) and correlated with both plasma renin
activity (r=0.83) and arterial pressure (r=0.82). By 10 weeks, plasma renin
activity returned to baseline but arterial pressure remained elevated (144
+/-10 versus 115+/-5 mm Hg; P<0.05). Isoprostane levels remained high and s
till correlated directly with the increase in arterial pressure (r=0.7) but
not with plasma renin activity. Stenotic kidney blood flow was decreased a
t both studies. In shock-frozen cortical tissue, ex vivo endogenous intrace
llular radical scavengers were significantly decreased in both kidneys. The
present study demonstrates, for the first time, that in early renovascular
hypertension, an increase in plasma renin activity and arterial pressure i
s associated with increased systemic oxidative stress. When plasma renin ac
tivity later declines, PGF(2 alpha)-isoprostanes remain elevated, possibly
due to local activation or slow responses to angiotensin II, and may partic
ipate in sustenance of arterial pressure, Moreover, oxidation-sensitive mec
hanisms may influence ischemic and hypertensive parenchymal renal injury.