[Peculiarities of the renin-angiotensin-aldosterone-system in elderly patients with ischaemic heart diseases (author's transl)].

An investigation into the renin-angiotensin-aldosterone system (RAAS) in patients of advanced age with ischaemic heart disease (IHD) and different degrees of atherosclerotic cardiosclerosis by means of radioimmunoassay, which was used to determine the renin activity and the aldosterone concentration in the plasma, showed that there is in IHD an activation of the above regulatory system even under the conditions of relative rest. Furthermore, it was found out that the renin activity of the plasma was increased only in male patients with IHD, whereas the aldosterone concentration was increased both in males and females. These findings justify the hypothesis on the pathogenetic role played by changes in the RAAS in IHD in old age. The more severe disorders of the RAAS as seen in male patients with IHD explain to some extent the earlier onset and greater severity of IHD in men. For the treatment of hyperaldosteronism, which has been found to be associated with IHD in persons of advanced age, it is necessary to include into the therapeutic plan of patients with IHD, in particular males, competitive aldosterone antagonists as well as beta-adrenergic blocking agents.