Abnormally sustained aldosterone secretion during salt loading in patients with various forms of benign hypertension; relation to plasma renin activity
| Autor: | Gonzales Cm, Collins Rd, John A. Luetscher, Dowdy Aj, Nokes Gw, Myron H. Weinberger |
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| Rok vydání: | 1970 |
| Předmět: |
Adult
medicine.medical_specialty Adrenocortical Hyperfunction Adolescent Renal Artery Obstruction Essential hypertension Plasma renin activity Excretion chemistry.chemical_compound Internal medicine Hyperaldosteronism Renin Renin–angiotensin system medicine Humans Aldosterone Angiotensin II Sodium Articles General Medicine Adrenocortical hyperfunction medicine.disease Endocrinology chemistry Hypertension Potassium Contraceptives Oral |
| Zdroj: | Journal of Clinical Investigation. 49:1415-1426 |
| ISSN: | 0021-9738 |
| DOI: | 10.1172/jci106359 |
| Popis: | A B S T R A C T Among 25 patients with benign, essential hypertension, and an equal number with other benign forms of hypertension, without serious cardiac, renal, or cerebrovascular impairment, 41 cases failed to reduce aldosterone excretion rates into the normal range (less than 5 Ag/day) on a daily intake of 300 mEq of sodium. The hypertensive patients excreted slightly less than the normal fraction of labeled aldosterone as acidhydrolyzable conjugate. Secretion rates were significantly higher in the hypertensive patients than in normotensive controls taking the high-sodium intake. On a 10 mEq sodium intake, the increase in excretion and secretion rates of aldosterone in the hypertensive patients could be correlated with plasma renin activity (PRA). The patients with the least increase in PRA had subnormal increase in aldosterone secretion and excretion, while unusually large rises in aldosterone secretion accompanied high PRA, especially in the cases with increased plasma angiotensinogen induced by oral contraceptives. The persistence of inappropriately high aldosterone secretion in most hypertensive patients during sodium loading could be related to a higher PRA than that found in normotensive controls under comparable conditions. In other hypertensives, whose PRA was unresponsive to sodium depletion, there was no significant correlation between PRA and aldosterone output, and no known stimulus to aldosterone production was detected. Five obvious cases of hyperaldosteronism were found among the 16 low-renin patients. The cause of the nonsuppressible aldosterone production in the other -low-renin cases remains to be determined. |
| Databáze: | OpenAIRE |
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