Inappropriate Elevation of the Aldosterone/Plasma Renin Activity Ratio in Hypertensive Patients with Increases of 11-Deoxycorticosterone and 18-Hydroxy-ll-Deoxycorticosterone: A Subtype of Essential Hypertension?

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Among 436 patients with hypertension unrelated to any renal lesion, renovascular damage, pheochromocytoma, Cushing’s syndrome or hyperthyroidism, 15 patients had low plasma renin activity (PRA) and elevated plasma aldosterone concentrations in the upright position and resultant high aldosterone/PRA ratios: 8 with aldosterone-producing adenoma (APA; group 1) and 7 with idiopathic hyperaldosteronism (IHA; group 2). Thirtynine patients had suppressed PRA in the presence of normal plasma aldosterone levels and moderately elevated aldosterone/PRA ratios (group 3). Thirty of them had elevated plasma 11-deoxycorticosterone (DOC) and 18-hydroxy-ll-deoxycorticosterone (18-OH-DOC) concentrations (group 3a) and 9 of them had normal levels of those mineralocorticoids (group 3b). The rest of them (382 patients) had low aldosterone/PRA ratios (group 4). Adrenal scintigraphy with dexamethasone pretreatment revealed [131I]-cholesterol accumulation not only in patients with APA (unilateral) or IHA (bilateral), but also in patients of group 3a (bilateral). In patients in groups 3a and 3b adrenal size (especially thickness), as measured by computed tomography (CT scan), was enlarged, as in patients with IHA (group 2), and was significantly greater than in patients of group 4 (p < 0.001). Spironolactone reduced blood pressure in all tested patients of group 3a, and the removal of adrenal tumor or hyperplastic tissue normalized blood pressure in patients of groups 1, 2 and 3a. Excised adrenal glands exhibited cortical hyperplasia with or without nodular hyperplasia in patients of group 3a. Good agreement was found between the actual size of the excised tissue and the measurement obtained by CT scan. Since β-endorphin and β-lipotropin were depressed in patients of group 3a, it is suggested that an unknown pituitary substance stimulates the adrenal cortex to release too large amounts of DOC and 18-OH-DOC and inappropriate secretion of aldosterone.

Related collections

Author and article information

Journal

Journal ID (publisher-id): CRD

Journal ID (nlm-ta): Cardiology

Journal ID (doi): 10.1159/issn.0008-6312

Title: Cardiology

Publisher: S. Karger AG

ISSN (Print): 0008-6312

ISSN (Electronic): 1421-9751

Publication date Subscription-year: 1991

Publication date (Print): 1991

Publication date (Electronic): 12 November 2008

Volume: 78

Issue: 2

Pages: 99-110

Affiliations

^aDepartment of Geriatrics, Endocrinology and Metabolism, Shinshu University School of Medicine, Matsumoto, Nagano; ^bDepartment of Medicine, Musashino Red Cross Hospital, Hachi-ohji, Tokyo; ^cDepartment of Pathology, Nagano Cancer Institute, Matsumoto, Nagano; ^dDepartment of Urology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan

Article

Publisher ID: 174773 Other ID: Cardiology 1991;78:99–110

DOI: 10.1159/000174773

PubMed ID: 2070375

SO-VID: 6322c56c-d76b-4757-bc44-cfe4a0efc5f6

License:

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 09 May 1990

Date accepted : 14 September 1990

Page count

Pages: 12

Inappropriate Elevation of the Aldosterone/Plasma Renin Activity Ratio in Hypertensive Patients with Increases of 11-Deoxycorticosterone and 18-Hydroxy-ll-Deoxycorticosterone: A Subtype of Essential Hypertension?

Read this article at

Abstract

Related collections

Karger: Cardiovascular System

Author and article information

Journal

Affiliations

Article

History

Page count

Categories

Comments

Comment on this article

Similar content 137

Cited by 1