SUMMARY The effects of graded lower body negative pressure (-10 and -40 mm Hg) on vascular resistance and plasma vasopressin, norepinephrine, and renin activity were assessed in seven hypertensive subjects with left ventricular hypertrophy and seven sex-matched and age-matched normotensive subjects. In both groups increasing levels of lower body negative pressure induced a progressive decrease in right atrial pressure and an increase in vascular resistance. In normal subjects plasma vasopressin, norepinephrine, and renin activity were progressively raised, whereas only the higher level of stimulation increased plasma renin activity, norepinephrine, and vasopressin in hypertensive subjects. Propranolol induced a significant increase in plasma vasopressin in normal subjects (from 1.3 ± 0.1 to 2.0 ± 0.1 pg/ml; p<0.05) but not in hypertensive subjects. In this latter condition -10 mm Hg lower body negative pressure failed to increase plasma vasopressin, norepinephrine, and renin activity in normal subjects. Propranolol abolished the change in plasma renin activity in both groups, reduced the increase in vascular resistance induced by -40 mm Hg lower body negative pressure in normotensive subjects, but did not modify the rise in vasopressin elicited by this stimulus in normal subjects or the humoral and hemodynamic reflex responses evoked in hypertensive subjects. These results suggest that cardiopulmonary receptors are involved in the control of vasopressin release in normal subjects, whereas in hypertensive subjects with left ventricular hypertrophy, this control is altered because of an impaired function of cardiopulmonary receptors. (Hypertension 10: 595-602, 1987) KEY WORDS • propranolol • lower body negative pressure • norepinephrine A LTHOUGH the sensitivity of the nonosmotic / \ control of arginine vasopressin (AVP) release A. JL. in humans seems to be somewhat controversial, 1 " 4 recent reports 5 ' 6 support the hypothesis that factors other than blood osmolarity are involved in the regulation of AVP release in humans. In particular, Leimbach et al. 5 demonstrated that combined unloading of cardiac and arterial baroreceptors induced by lower body negative pressure (LBNP) increases plasma AVP in subjects with high plasma osmolality. Egan et al. 6 reported that the selective unloading of cardiopulmonary receptors, by thigh-cuff inflation, increases plasma AVP levels in humans. These observations raise the possibility that AVP release may be altered in patients with impaired cardiopulmonary or arterial baroreceptor reflex responsiveness.From the Istituto di Clinica Medica I, II Facolta di Medicina e Chirurgia, Universita di Napoli, Italy.Address for reprints: Bruno Trimarco, M.D., Istituto di Clinica Medica I, II Facolta di Medicina, via S. Pansini 5, 80131 Napoli, Italy.Received November 4, 1986; accepted June 30, 1987. In patients with established hypertension, we observed that the postural change from the supine to the upright position did not induce the rise in AVP plasma levels observed in normote...