Document Detail


Are there unknown mineralocorticoids in low-renin essential hypertension?
MedLine Citation:
PMID:  323587     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The blood pressure elevation of primary aldosteronism is caused by excessive production of the known mineralocorticoid, aldosterone. The blood pressure elevation of low-renin essential hypertension may also be caused by mineralocorticoid excess, but which which mineralocorticoid is responsible is uncertain. Normal levels of aldosterone, found in this disorder despite suppressed plasma renin, and the presence of an unknown mineralocorticoid have been hypothesized to explain low-renin essential hypertension. We contrasted the blood pressure responses and changes in aldosterone seen in patients with low-renin essential hypertension and primary aldosteronism during treatment with two adrenal enzyme inhibitors. The results demonstrate the similarity between decrease in blood pressure and in aldosterone during early adrenal inhibition in both primary aldosteronism and in low-renin essential hypertension. During treatment with a distal adrenal blocker, patients with primary aldosteronism demonstrated decreases in both aldosterone and blood pressure, whereas patients with low-renin essential hypertension showed a decrease in aldosterone without significant change in blood pressure. This suggested that aldosterone was not the major mineralocorticoid responsible for low-renin essential hypertension. Unknown mineralocorticoid excretion decreased (along with blood pressure) during early inhibition but failed to decrease (along with blood pressure) during late inhibition at a time when aldosterone excretion decreased. This suggests that unknown mineralocorticoids play significant roles in the blood pressure elevation of low-renin essential hypertension.
Authors:
J W Hollifield; P E Slaton; H M Wilson; J A Sennett; L Yarbro; D P Island; G W Liddle
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Mayo Clinic proceedings. Mayo Clinic     Volume:  52     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  1977 May 
Date Detail:
Created Date:  1977-06-30     Completed Date:  1977-06-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  329-33     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aminoglutethimide / pharmacology
Blood Pressure
Clinical Trials as Topic
Humans
Hyperaldosteronism / physiopathology
Hypertension / etiology,  physiopathology*
Metyrapone / pharmacology
Mineralocorticoids / secretion*
Posture
Renin / secretion
Chemical
Reg. No./Substance:
0/Mineralocorticoids; 125-84-8/Aminoglutethimide; 54-36-4/Metyrapone; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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