Characterization of a group of essential hypertensives with impaired regulation of aldosterone.
The pattern of aldosterone excretion during high sodium intake in 100 patients with essential hypertension allowed the differentiation of two groups: in the majority of patients (group A, n = 64) aldosterone excretion was suppressed below 6 micrograms/day similar to the normotensive control group. In a second group (group B, n = 36), aldosterone remained above the control range despite forced sodium loading. In group B, serum potassium was significantly lower than in patients of group A (3.81 +/- 0.44 meq/l vs. 4.26 +/- 0.57 meq/l, p less than 0.001). The blood pressure lowering effect of spironolactone (200 mg/d) was more pronounced among patients in group B. Plasma renin values tended to be lower in group B compared to patients with suppressed aldosterone. Infusion of Angiotensin II (0.1 - 2 micrograms/kg/min) led to a similar relative rise of plasma aldosterone levels in both groups despite higher baseline values in group B. The exact mechanism of the impaired regulation of aldosterone in a subgroup of patients with essential hypertension remains to be elucidated.
D000236:Adenoma / Q000378:metabolism; D000310:Adrenal Gland Neoplasms / Q000378:metabolism; D000328:Adult; D000450:Aldosterone / Q000378:metabolism* / Q000652:urine; D000804:Angiotensin II; D005260:Female; D006801:Humans; D006973:Hypertension / Q000378:metabolism*; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood / Q000652:urine; D012083:Renin / Q000097:blood; D012964:Sodium / Q000652:urine; D013148:Spironolactone / Q000627:therapeutic use
D000804:Angiotensin II; D013148:Spironolactone; D000450:Aldosterone; D012964:Sodium; D012083:Renin; D011188:Potassium