Abstract
The effect of indomethacin on plasma renin activity (PRA), urinary aldosterone, 17 OH ketogenic steroids and plasma Cortisol was studied in twenty-three patients with essential hypertension and compared in eleven patients to Oxprenolol effect by 2 x 2 factorial trial. Indomethacin decreased PRA and urinary aldosterone: its effect was maintained when the drug was given for three days and it was related to basal PRA and aldosterone values. Therefore in patients with low PRA (renin-sodium index) PRA and aldosterone were unchanged, while they decreased in the normal high PRA group. Aldosterone changes were related to those of PRA, while 17 OH ketogenic steroids and plasma Cortisol were unchanged. Both indomethacin and Oxprenolol decreased PRA, but no interaction or additive effect was found between the two drugs. The present data indicate that indomethacin can decrease both PRA and aldosterone to an extent which is related to basal values and that aldosterone changes are mainly explained by those of PRA. The PRA unresponsiveness to indomethacin found in low renin patients may suggest renal prostaglandin deficiency. Finally the lack of interaction or of additive effect between indomethacin and Oxprenolol may be explained by postulating either that the two drugs act on a common pathway or that an additive effect on PRA cannot be detected renin being maximally suppressed by full renal beta-receptors blockade.
Similar content being viewed by others
References
Barger A.C., Herd J.A. Study of renal circulation in the unanesthetized dog with inert gases: external counting. In: Proc. 3rd Int. Congr. Nephrol. Karger, Basel, 1967, p. 174.
Lee J.B. Chemical and physiological properties of renal prostaglandins, the antihypertensive effect of medullin in essential hypertension. In: Prostaglandins: II Nobel Symp. Almquist and Wiksell, Stockolm 1967, p. 197.
Weber P.C., Larsson C., Anggard E., Hamberg M., Corey E.S., Nicolau K.C., Samuelsson B. Stimulation of renin release from rabbit renal cortex by arachidonic acid and prostaglandin endoperoxides. Circ. Res. 39: 868, 1976.
Saruta T., Kaplan N.M. Adrenocortical steroidogenesis: the effects of prostaglandins. J. Clin. Invest 51: 2246, 1972.
Peng T., Six K.M., Munson P.L. Effects of prostaglandin E1 on the hypothalamo-hypophy-seal-adrenocortical axis in rats. Endocrinology 86: 202, 1970.
Yun J., Kelly G., Bartter F.G., Smith H. Role of prostaglandins in the control of renin secretion in the dog. Circ. Res. 40: 459, 1977.
Golub M.S., Speckart P.F., Zia P.K., Horton R. The effect of prostaglandin A1 on renin and aldosterone in man. Circ. Res. 39: 574, 1977.
Flower R., Gryglewski R., Herbaczynska-Cedro K., Vane J.R. Effects of antiinflammatory drugs on prostaglandin biosynthesis. Nature (New Biol.) 238: 104, 1972.
Flower R.J. Drugs which inhibit prostaglandin biosyntesis. Pharmacol. Rev. 26: 33, 1974.
Salvetti A., Sassano P., Arzilli F., Gazzetti P. The relationship between PRA and daily rate of urinary sodium excretion. J. Nucl. Biol. Med. 18: 119, 1974.
Malvano R., Zucchelli G.C., Rosa U., Salvetti A. Measurement of plasma renin activity by angiotensin I radioimmunoassay (I): an assessment of some methodological aspects. J. Nucl. Biol. Med. 16: 24, 1972.
Clerico A., Del Chicca M.G., Zucchelli G.G., Materazzi F. Evaluation and comparison of four methods for plasma Cortisol assay. J. Nucl. Biol. Med. 20: 119, 1976.
Malvano R., Orlandini S., Cozzani P., Duranti P., Simonini N., Salvetti A. Methodological simplifications in radioimmunoassay of urinary aldosterone. Clin. Chim. Acta 66: 331, 1976.
Few J.D. A method for the analysis of urinary 17-hydroxycortico- steroids. J. Endocrinol. 22: 31, 1961.
Chasson A.L., Grady H.J., Stanley M.A. Determination of creatinine by means of automatic chemical analysis. Am. J. Clin. Pathol. 35: 83, 1961.
Snedecor G.W., Cochran W.G. Statistical methods VI Ed. Iowa State University Press. Ames 1967.
Romero J.C., Dunlap C.L., Strong C.G. The effect of indomethacin and other antiinflammatory drugs on the renin-angiotensin system. J. Clin. Invest 58: 282, 1976.
Rumpf K.W., Frenzel S., Lowitz H.D., Scheler F. Die Wirkung von Indomethacin auf die basale und stimulierte Plasma Renin Activität bei Menschen. Klin. Woschenschr. 54: 255, 1976.
Feldman D., Couropmitree C. Intrinsic mineralcorticoid agonist activity of some steroidal antiinflammatory drugs. J. Clin. Invest. 57: 1, 1976.
Michelakis A.M., Claude J., Liddle G.M. In vitro stimulation of renin production of epinephrine, norepinephrine and cyclic AMP. Proc. Soc. Exp. Biol. Med. 130: 748, 1969.
Salvetti A., Arzilli F., Poli L, Pedrinelli R., Sassano P., Parisi S., Motolese M. Effects of therapy on the renin-angiotensin-aldosterone system of hypertensive patients. International Symposium: The endocrine function of the human adrenal cortex. Florence 4–7 Oct. 1977, p. 63.
Frolich J.C., Hollifield W., Oates J.A. Effect of indomethacin on isoproterenol induced renin release. Clin. Res. 24: 9A, 1976.
Brooks C.S., Tawalker R.T., Kotchen T.A. Renin reactivity in plasma of patients with normal renin and low renin essential hypertension. J. Clin. Endocrinol. Metab. 44: 322, 1977.
Laragh J.H., Angers M., Kelly W.G., Lieberman S. Hypotensive agents and pressor substances. JAMA 174: 234, 1960.
Donker A.J.M., Arisz L, Brentjens J.R.H., Van Der Hem G.K., Holleman H.J.G. The effect of indomethacin on kidney function and plasma renin activity in man. Nephron 17:288, 1976.
Usberti M., Milerri M., Maiorca R. Effect of indomethacin on renal function. Kidney Int. 7a: 197, 1975.
Martinez-Maldonando M., Tsapara M.N., Eknoyan G., Suki W.N. Renal actions of prostaglandins: comparisons with acetylcholine and volume expansion. Am. J. Physiol. 222: 1147, 1972.
Strandhoy J.W., Ott C.E., Schneider E.G., Willis LR., Beck N.P., Davis B.B., Knox F.G. Effect of prostaglandins E2 and E2 on renal sodium reabsorption and Starling forces. Am. J. Physiol. 226: 1015, 1974.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pedrinelli, R., Arzilli, F., Cavasinni, L. et al. The effect of indomethacin on plasma renin activity and urinary aldosterone of patients with essential hypertension. J Endocrinol Invest 1, 315–320 (1978). https://doi.org/10.1007/BF03350976
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03350976