Renin plays important role in –
**Core Concept**
Renin is a crucial enzyme involved in the regulation of blood pressure through the renin-angiotensin-aldosterone system (RAAS). It plays a pivotal role in the pathogenesis of various hypertensive disorders by initiating a cascade of events that ultimately lead to vasoconstriction and fluid retention.
**Why the Correct Answer is Right**
Renin's role in renovascular hypertension is well-established. When the kidneys detect a decrease in renal perfusion, such as in stenotic renal arteries, they release renin, which triggers the conversion of angiotensinogen to angiotensin I and subsequently to angiotensin II. Angiotensin II causes vasoconstriction and stimulates the release of aldosterone, leading to increased blood pressure and hypertension. In renovascular hypertension, the elevated levels of renin and angiotensin II are directly responsible for the pathogenesis of the disease.
**Why Each Wrong Option is Incorrect**
**Option B:** Malignant hypertension is characterized by severe and rapid elevation of blood pressure, often leading to target organ damage. While RAAS plays a role in the pathogenesis of hypertension, renin is not directly implicated in the development of malignant hypertension.
**Option C:** Coronary artery disease is primarily related to atherosclerosis and lipid metabolism, with RAAS playing a secondary role in the pathogenesis. Renin is not directly involved in the development of coronary artery disease.
**Option D:** Essential hypertension is a multifactorial disorder with a complex pathophysiology involving RAAS, but renin is not the primary mediator. The role of renin in essential hypertension is less clear compared to its role in renovascular hypertension.
**Clinical Pearl / High-Yield Fact**
Renin levels are often elevated in patients with renovascular hypertension, making it a useful diagnostic marker. A high renin-to-aldosterone ratio (R/A ratio) is particularly suggestive of renovascular hypertension, as opposed to primary aldosteronism.
**✓ Correct Answer: A. Renovascular hypertension**