Summary
The pattern of aldosterone excretion during high sodium intake in 100 patients with essential hypertension allowed two groups to be differentiated: In the majority of patients (group A, n = 64), aldosterone excretion was suppressed below 6 µg/day, similar to the level in 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, respectively, P < 0.001). The blood-pressure-lowering effect of spironolactone (200 mg/day) was more pronounced among patients in group B. Plasma renin values tended to be lower in group B compared with patients showing suppressed aldosterone. The infusion of angiotensin II (0.1–2 ng/kg body weight/min) led to a more pronounced increase in plasma aldosterone levels in group-B patients compared to group A essential hypertensives, starting from higher plasma-aldosterone baseline values in group B-patients.
The exact mechanism of impaired regulation of aldosterone in a subgroup of patients with essential hypertension remains to be elucidated.
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Helber, A., Wambach, G., Hummerich, W., Meurer, K.A. (1983). Mineralocorticoids in Essential Hypertension. In: Kaufmann, W., Wambach, G., Helber, A., Meurer, KA. (eds) Mineralocorticoids and Hypertension. International Boehringer Mannheim Symposia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69081-5_15
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DOI: https://doi.org/10.1007/978-3-642-69081-5_15
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