Modulation of target tissue response to angiotensin II and sodium sensitivity in Japanese patients with essential hypertension.
"Non-modulators" are essential hypertensive patients who fail to modulate an adrenal response, renovascular response, or both, to angiotensin II (Ang II). The aim of the present study was to characterize "non-modulators" among Japanese patients with normal-renin essential hypertension and to determine whether non-modulation is related to sodium sensitivity of blood pressure. The increase in plasma aldosterone concentration (PAC response) and the decrease in renal plasma flow (RPF response) in response to Ang II infusion (3 ng/kg/min) were assessed in 15 Japanese patients with essential hypertension who received a high sodium diet (250 mEq/d) followed by a low sodium diet (10 mEq/d). The subjects were divided into two groups (6 modulators and 9 non-modulators) based on their ability to modulate the PAC response during sodium restriction. There was no significant difference between modulators and non-modulators in electrolyte balance or in plasma Ang II levels on either diet. Changes in the PAC response during sodium restriction were significantly correlated with the change in mean blood pressure during sodium restriction (r = -0.67, p < 0.01), while changes in the RPF response were not. RPF responses in both groups decreased during sodium restriction, although an effect on the RPF response in non-modulators was unexpected. These results suggest that non-modulators do exist among Japanese patients, but that this defect does not involve both the adrenal gland and the kidney. Apparently, only non-modulation of the adrenal response is involved in the mechanism of sodium sensitivity.
Department of Clinical Laboratory Medicine, Hiroshima University School of Medicine, Japan.
R
R
Ozono
H
H
Matsuura
T
T
Oshima
K
K
Ishibashi
M
M
Ishida
T
T
Ishida
M
M
Watanabe
G
G
Kajiyama
M
M
Kambe
D000328:Adult; D000450:Aldosterone / Q000378:metabolism; D000804:Angiotensin II / Q000008:administration & dosage*; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System; D012965:Sodium Chloride / Q000008:administration & dosage*
D000804:Angiotensin II; D012965:Sodium Chloride; D000450:Aldosterone