Hormone and blood pressure relationships in primary aldosteronism.
We used continuous intra-arterial pressure monitoring and hourly venous hormone sampling over 24 hours in 5 patients with primary aldosteronism to study blood pressure and hormone regulation. Three patients were restudied under identical conditions of controlled diet electrolyte intake and body posture 3-7 months after removal of the aldosterone-secreting adrenal tumor. Prior to surgery there was no positive relationship of arterial pressure to renin or to aldosterone. Norepinephrine fluctuations showed positive correlations with arterial pressure but these 2 indices were more closely related after surgery. Plasma aldosterone levels paralleled those of cortisol both before and after cure of primary aldosteronism. Aldosterone/cortisol regression lines were steeper before surgery, and norepinephrine/renin regression lines were steepened in the post-operation studies. Our findings indicate that in established primary aldosteronism, fluctuations in arterial pressure are regulated in part by the sympathetic nervous system: the pattern of aldosterone secretion is controlled mainly by ACTH: aldosterone responsiveness to endogenous ACTH is enhanced: and sympathetic modulation of renin release in inhibited.
D000236:Adenoma / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000601:surgery; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D001794:Blood Pressure; D002940:Circadian Rhythm; D004837:Epinephrine / Q000097:blood; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D006929:Hyperaldosteronism / Q000503:physiopathology*; D009638:Norepinephrine / Q000097:blood*; D011188:Potassium / Q000097:blood; D012083:Renin / Q000097:blood
D000450:Aldosterone; D012083:Renin; D011188:Potassium; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine