Increased Metabolic Turnover Rate and Transcapillary Escape Rate of Albumin in Essential Hypertension

The metabolic turnover rate and the transcapillary escape rate of albumin were studied using 131 I-labeled human albumin in nine untreated subjects suffering from essential hypertension. The average mean arterial blood pressure of these subjects was 162/109 mm Hg; seven subjects had grade I-II funduscopic changes. Plasma albumin concentration was normal, but plasma volume was reduced ( P < 0.05) in these subjects. Thus, the previously reported moderate decrease in the intravascular albumin mass of hypertensive subjects was confirmed; the average value for intravascular albumin mass in the present study was 62.8 g/m2 surface area compared with a normal value of 70.6 g/m 2 (-11%, P < 0.05). A surprising finding was a marked enhancement of albumin metabolic rate in essential hypertension. The fraction of intravascular albumin mass metabolized per 24-hour period was on the average 14.4% compared with a normal value of 8.4% (+72%, P < 0.001). The rate of synthesis was 9.1 g/24 hours m -2 compared with a normal value of 5.9 g/24 hours m -2 (+54%, P < 0.001). Total body albumin mass was decreased proportionally to intravascular albumin mass. Confirming a previous observation, we found an increase in the transcapillary escape rate of albumin (fraction of intravascular mass passing to the extravascular space per unit time) from a normal average of 5.6%/hour to 7.5%/hour (+34%, P < 0.001). There was a statistically significant positive correlation between the transcapillary escape rate of albumin and blood pressure ( P < 0.05). These findings can best be explained by increased filtration due to the high arterial blood pressure. There was also a positive correlation between the transcapillary escape rate and the fractional catabolic rate of albumin ( P < 0.05). This finding supports the concept that albumin is catabolized in connection with its permeation through the capillary endothelium.