Suppression of Plasma Renin Activity in Primary Aldosteronism

Conn, Jerome W.; Cohen, Edwin L.; Rovner, David R.

doi:10.1001/jama.1964.03070160037008

Cited by 225 publications

(35 citation statements)

References 13 publications

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“…The suppression of renin following DOCA implantation occurred after a 2-day period of sodium retention, and was similar to the suppressed PRA seen in other mineralocorticoid excess states. 10 Despite the rapid fall in renin, plasma aldosterone levels were not different from controls during the first week after implant, and subsequent suppression of aldosterone in DOCA pigs was never as complete as the concomitant suppression of renin. This was unexpected, as DOCA administration in man results in prompt suppression of aldosterone.…”

Section: Weight Measurementsmentioning

confidence: 87%

Electrolyte and hormonal effects of deoxycorticosterone acetate in young pigs.

Grekin

Terris²,

Bohr³

1980

Hypertension

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SUMMARY Balances of sodium, potassium, and water were studied in the growing male pig as hypertension developed in response to subcutaneous implantation of deoxycorticosterone acetate (DOCA). Serum sodium, potassium, deoxycorticosterone (DOC), aldosterone, and plasma renln actirity (PRA) were determined. These variables were observed in a total of 10 experimental and nine control pigs. All animals were uninephrectomized and fed a diet of Purina Pig Chow and tap water ad libitum. No salt was added to the food or water. Serum DOC levels rose dramatically on the day of the implantation, then gradually declined but remained approximately 10 times greater than control levels 40 days after Implant.Plasma renln activity was suppressed rapidly and completely, whereas aldosterone fell only slowly to about half its control value. Sodium retention was maximum during the first 24 hours. Thereafter an "escape" process became operative, causing sodium balance to return to normal after the third day, at which time the major rise in arterial pressure occurred. A marked increase in water turnover (intake and output) also began after the third day and persisted throughout the experimental period. Water balance remained normal during this period of increased turnover. Hypokalemia developed in the absence of kaliuresis, suggesting that potassium moved Into the cells. Except for the potassium retention, these changes parallel the abnormalities seen in other states of mineralocorticoid excess. • * Despite the large number of studies performed upon these experimental models, the pathogenesis of hypertension remains controversial.We have developed an animal model for mineralocorticoid hypertension using deoxycorticosterone acetate (DOCA) implantation in pigs, which offers several advantages for the study of hypertension. These include the rapid and highly reproducible elevation in blood pressure and the relatively large size of the animal, which allows for accurate hemodynamic measurements." In this report we describe the electrolyte and hormonal changes seen during the development of DOCA hypertension in pigs.

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Section: Weight Measurementsmentioning

confidence: 87%

Electrolyte and hormonal effects of deoxycorticosterone acetate in young pigs.

Grekin

Terris²,

Bohr³

1980

Hypertension

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“…The patients were hospitalized and given a daily diet containing 209 meq sodium to avoid stimulation of PRA. Urine was collected contintuously in 24-h aliquots for determinations of' creatiniine, sodium, potassiumil, 1 (17) by previously published methodls. PRA was measured at Hazletoni Laboratories, Vienna, Va., under contract no.…”

Section: Methodsmentioning

confidence: 99%

Effect of Aminoglutethimide on Blood Pressure and Steroid Secretion in Patients with Low Renin Essential Hypertension

et al. 1978

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A B S T R A C T An inhibitor of adrenal steroid biosynthesis, aminoglutethimide, was administered to seven patients with low renin essential hypertension, and the antihypertensive action of the drug was compared with its effects on adrenal steroid production. In all patients aldosterone concentrations in plasma and urine were within normal limits before the study. Mean The gradual lowering of blood pressure and body weight during aminoglutethimide therapy is consistent with the view that the antihypertensive effect of the drug is mediated through a reduction in the patients' extracellular fluid volume, probably secondary to the persistent decrease in aldosterone production. The observation that chronic administration of aminoglutethimide lowered blood pressure in these patients and elevated their plasma renin activity to the normal range without decreasing production of the adrenal steroids, deoxycorticosterone, 18-hydroxydeoxycorticosterone, and 16,3-hydroxydehydroepiandrosterone, makes it unlikely that these steroids are responsible either for the decreased renin or the elevated blood pressure in patients with low renin essential hypertension.

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“…Only in primary aldosteronism does there appear to be a disparity between aldosterone secretion and plasma renin activity, for in this disease, aldosterone secretion remains elevated whereas plasma renin activity (PRA) remains depressed (7). Plasma renin activity does exhibit postural and day-to-day variations (8) in primary aldosteronism but these changes are thought to be of such a small order of magnitude as to be of no significance in the control of aldosterone secretion.…”

Section: Introductionmentioning

confidence: 99%

Activation of aldosterone secretion in primary aldosteronism

Spark¹,

Dale²,

Kahn³

et al. 1969

J. Clin. Invest.

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A B S T R A C T Angiotensin infusion evokes marked increases in aldosterone secretion in primary aldosteronism and little change in secondary aldosteronism. The low plasma renin activity of primary aldosteronism and the elevated plasma renin activity of secondary aldosteronism are thought to account for this differential response. The effect of angiotensin on aldosterone and 18-hydroxycorticosterone secretion was studied during adrenal vein catheterization in seven patients with primary aldosteronism (whose plasma renin activity had been elevated following spironolactone therapy), one hypertensive patient with normal plasma renin activity and normal aldosterone secretion, two patients with secondary aldosteronism who had elevated plasma renin activity, and one anephric patient whose plasma renin activity was 0. Adrenal venous aldosterone and 18-hydroxycorticosterone were measured before and after a ten min sub-pressor angiotensin infusion.

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Suppression of Plasma Renin Activity in Primary Aldosteronism

Cited by 225 publications

References 13 publications

Electrolyte and hormonal effects of deoxycorticosterone acetate in young pigs.

Electrolyte and hormonal effects of deoxycorticosterone acetate in young pigs.

Effect of Aminoglutethimide on Blood Pressure and Steroid Secretion in Patients with Low Renin Essential Hypertension

Activation of aldosterone secretion in primary aldosteronism

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