Key result
Hypertensive patients show blunted aldosterone responses to volume shifts but retain responsiveness to potassium.
Why the study?
The influence of body water volume and potassium supply on aldosterone excretion in patients with arterial hypertension compared to normotensive individuals was unclear.
Does the manipulation of body water volume and potassium supply alter aldosterone excretion differently in hypertensive patients compared to normotensive subjects?
Does the manipulation of body water volume and potassium supply alter aldosterone excretion differently in hypertensive patients compared to normotensive subjects?
Aldosterone production in hypertensive patients responds abnormally to changes in body water volume but remains responsive to potassium supply.
Answers are grounded in this paper and cite their sources.
Blunted aldosterone response to volume expansion in hypertension suggests dysregulation; leaves open mechanisms and clinical relevance.
Considerable volumes of iso-osmotic glucose solution were infused intravenously into healthy volunteers and patients with arterial hypertension. The aldosterone escretion decreased during and subsequently to the infusion in the normotensives whereas it did not change in the majority of the hypertensives. In some cases the excretion even rose.A thiazide diuretic was given to normal subjects and to hypertensive patients on an ordinary diet and on a sodium restricted diet. In the normotensives the ensuing sodium and water loss was rapidly followed by a considerable, compensatory increase of the aldosterone excretion in the urine. The hypertensive patients, when given the thiazide derivative, lost similar amounts of sodium chloride and water, but, with only three exceptions, their aldosterone excretion did not increase. When potassium chloride was given during the thiazide treatment, wither to healthy subjects or to patients with hypertensive disease, the aldosterone excretion always became considerably augmented.It is suggested that the aldosterone production in patients with hypertensive disease the body water volume and/or to changes in the potassium supply.
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Josephson et al. (1962) studied Arterial hypertension. Iso-osmotic glucose solution, thiazide diuretic, and potassium chloride vs. Normotensive healthy volunteers was evaluated on Aldosterone excretion. Aldosterone excretion in hypertensive patients failed to decrease after glucose infusion or increase after thiazide-induced volume loss compared to normotensives, but increased with potassium supply.
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