1. Because hypertension is the central feature of pre-eclampsia, and because plasma renin activity is known to be elevated in normal pregnancy (with conflicting results published for pre-eclampsia), a prospective study of plasma renin activity was conducted in pregnancy, under conditions of a fixed sodium intake, in 178 initially normotensive volunteer subjects. Thirty of these women developed pregnancy-associated hypertension (pre-eclampsia) in the third trimester.
2. There was a significant elevation of plasma renin activity from the published values for non-pregnant women, throughout gestation in normotensive women. There was no significant difference, at any stage of gestation, between the values for normal women and those who developed pregnancy-associated hypertension.
3. The extent of cryoactivation of renin, produced by usual collection procedures, was investigated in a subgroup of the total population. It was highly significant and quite variable, but was similar in those who developed pregnancy-associated hypertension and in normal pregnant women. The mean increase in plasma renin concentration in maximally cryoactivated samples was 16-fold.
4. Neither measurement of peripheral plasma renin activity nor of cryoactivatable plasma renin concentration is of value in distinguishing between normal pregnant women and those destined for, or with pregnancy-associated, hypertension.