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The substitutive role of ACTH in supporting aldosterone response to head-up tilt during acute renin suppression in patients with essential hypertension.
Metadata
Journalhypertension7.713Date
1979-Mar-Apr
Type
Research Support, U.S. Gov't, P.H.S.
Journal Article
Volume
1979-Mar-Apr / 1 : 130-5
Author
Morganti A , Sealey JE , Lopez-Ovejero JA , Pickering TG , Laragh JH
DoiPMIDMESH
Adrenergic beta-Antagonists
Adrenocorticotropic Hormone
Adult
Aldosterone
Blood Pressure
Female
Humans
Hypertension
Male
Middle Aged
Posture
Renin
Abstract
The relative contribution of the renin-angiotensin system, adenocorticotrophic hormone (ACTH) and plasma electrolytes in the response of plasma aldosterone to 30 minutes of 65 degrees head-up tilt was assessed in 10 essential hypertensive patients. Studies were carried out before and during acute blockade of renin release by propranolol, ACTH suppression by dexamethasone and combined renin and ACTH blockade. In control studies orthostasis induced significant increases only in plasma renin activity and aldosterone. In contrast, when the renin response to tilt was acutely suppressed by propranolol administration, the aldosterone response was nonetheless maintained but now appeared to be under ACTH control, since concurrent increases in cortisol were observed. During ACTH suppression aldosterone increased during tilt and so did renin. However, during combined ACTH and renin blockade aldosterone failed to increase during tilt. These studies suggest that the aldosterone secretory response to head-up tilt is normally mediated by the renin-angiotensin system but, when the renin response is suppressed, an ACTH response is elicited which assumes a backup role. However, when these two systems are blocked other factors appear unable to respond during tilt to support a normal aldosterone response.
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7.7
Hypertensionhypertension
Metadata
LocationUnited States
FromLIPPINCOTT WILLIAMS & WILKINS

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