The Relation of Arterial Pressure with Plasma and Body Electrolytes is Similar in Conn's Syndrome and Essential Hypertension

1982 ◽  
Vol 63 (s8) ◽  
pp. 89s-92s ◽  
Author(s):  
C. Beretta-Piccoli ◽  
D. L. Davies ◽  
J. J. Brown ◽  
J. B. Ferriss ◽  
R. Fraser ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Arterial Pressure ◽  
Potassium Concentration ◽  
Young Patients ◽  
Plasma Potassium ◽  
Surgical Removal ◽  
Exchangeable Sodium ◽  
Plasma Urea ◽  
Conn’S Syndrome

1. Arterial pressure, exchangeable sodium (NaE), exchangeable potassium (KE) and plasma concentrations of sodium, potassium, urea, angiotension II and aldosterone were measured in 34 patients with untreated Conn's syndrome before surgical removal of their adenoma. The study was repeated in 23 patients between 3 and 12 months after the operation. 2. Plasma aldosterone, NaE and plasma sodium concentration were higher and KE and plasma potassium concentration were lower than predicted normal. Surgery corrected these abnormalities, also reducing blood pressure from an average of 183/112 to 138/86 mmHg. 3. Systolic blood pressure was positively correlated with plasma and exchangeable sodium and negatively correlated with plasma potassium concentration. The relation of NaE and arterial pressure was closer in old than in young patients. None of these correlations was significant after operation. Before operation plasma urea was insignificantly related to arterial pressure but after operation a significant and positive correlation emerged. 4. A relation between arterial pressure and NaE is to be expected in a state of mineralocorticoid excess but the different correlation in old and young patients was not expected. A similar difference exists in patients with essential hypertension.

Relation of Arterial Pressure with Exchangeable and Total Body Sodium and with Plasma Exchangeable and Total Body Potassium in Essential Hypertension

1981 ◽  
Vol 61 (s7) ◽  
pp. 81s-84s ◽  
Author(s):  
C. Beretta-Piccoli ◽  
D. L. Davies ◽  
K. Boddy ◽  
J. J. Brown ◽  
A. M. M. Cumming ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Potassium Concentration ◽  
Young Patients ◽  
Plasma Potassium ◽  
Normal Subjects ◽  
Exchangeable Sodium ◽  
Total Body Potassium ◽  
Hypertensive Patients ◽  
Body Sodium ◽  
Total Body

1. Arterial pressure, plasma electrolytes and exchangeable sodium were measured in 91 patients with essential hypertension and in 121 normal control subjects. Total body sodium, exchangeable potassium and total body potassium were also measured in some of the hypertensive patients. 2. Mean plasma sodium concentration was slightly but significantly lower in the hypertensive patients as a group, but mean values for other electrolyte measurements were close to normal or predicted normal. 3. Exchangeable sodium was not related to arterial pressure in normal subjects but in hypertensive patients exchangeable sodium correlated significantly with systolic and diastolic pressures. These correlations were significant with two methods of expressing exchangeable sodium, in the whole group of patients, in men and in older patients. Exchangeable sodium was not significantly related to arterial pressure in young patients. 4. Total body sodium also correlated significantly with systolic and diastolic pressures in hypertensive patients. 5. Exchangeable sodium was significantly related to age in hypertensive patients but not in normal subjects. Mean exchangeable sodium was significantly lower than normal in young patients. 6. Plasma potassium concentration was not related to arterial pressure in normal subjects but in essential hypertensive patients plasma potassium concentration, exchangeable potassium and total body potassium correlated negatively with systolic and diastolic pressures. These correlations were also significant in young, but not in old patients.

Relation of Arterial Pressure with Body Sodium, Body Potassium and Plasma Potassium in Essential Hypertension

1982 ◽  
Vol 63 (3) ◽  
pp. 257-270 ◽  
Author(s):  
C. Beretta-Piccoli ◽  
D. L. Davies ◽  
K. Boddy ◽  
J. J. Brown ◽  
A. M. M. Cumming ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Arterial Pressure ◽  
Potassium Concentration ◽  
Plasma Potassium ◽  
Normal Subjects ◽  
Total Body Potassium ◽  
Hypertensive Patients ◽  
Body Sodium ◽  
Low Renin Hypertension ◽  
Total Body

1. Exchangeable sodium (NaE), plasma electrolytes and arterial pressure were measured in 121 normal subjects and 91 patients with untreated essential hypertension (diastolic >100 mmHg), 21 of whom had low-renin hypertension. Plasma concentrations of renin, angiotensin II and aldosterone were measured in all hypertensive patients, total body sodium, total body potassium and exchangeable potassium (KE) in some patients. 2. Mean NaE was not different in normal and hypertensive subjects provided the two groups were matched for leanness index. In the subgroup of young hypertensive patients aged 35 years or less mean NaE was below normal. NaE was not related to arterial pressure in normal subjects but in hypertensive patients there were positive and significant correlations of arterial pressure with NaE and with total body sodium. 3. NaE and total body sodium increased with age in hypertensive but not in normal subjects. Partial regression analysis suggested that the correlation of NaE with arterial pressure was not explained by an influence of age. 4. Mean NaE was not increased and mean KE was not decreased in patients with low-renin hypertension. 5. Plasma potassium concentration, KE and total body potassium correlated inversely and significantly with blood pressure in hypertensive patients. These correlations were more marked in young than in old patients. 6. Multiple regression analysis showed that the combination of NaE and plasma potassium concentration ‘explained’ more of the variation of systolic blood pressure in hypertensive patients than it did in normal subjects. Plasma potassium concentration ‘explained’ more of the variation in young hypertensives and NaE ‘explained’ more in older patients. 7. Our findings suggest that changes of plasma and body potassium are important in the earlier stages of essential hypertension and that changes of body sodium become important later.

Relationship between Exchangeable Sodium and Blood Pressure in Different Forms of Hypertension in Man

1979 ◽  
Vol 57 (s5) ◽  
pp. 69s-75s ◽  
Author(s):  
D. L. Davies ◽  
K. McElroy ◽  
A. B. Atkinson ◽  
J. J. Brown ◽  
A. M. M. Cumming ◽  
...  
Keyword(s):  
Renal Failure ◽  
Essential Hypertension ◽  
Chronic Renal Failure ◽  
Arterial Pressure ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Sodium Balance ◽  
Exchangeable Sodium ◽  
Conn’S Syndrome

1. Arterial pressure and exchangeable sodium (NaE) were measured in patients with Conn's syndrome, essential hypertension, renal artery stenosis and chronic renal failure. Comparison was made with a control group. Urine sodium excretion was measured separately from the two kidneys in patients with renal artery stenosis. 2. Compared with control, mean NaE was significantly increased in Conn's syndrome, and was normal in essential hypertension, renal artery stenosis and chronic renal failure. 3. The correlation of arterial pressure with NaE was positive and significant in Conn's syndrome, essential hypertension and chronic renal failure. 4. In contrast the correlation was significantly negative in unilateral renal artery stenosis. Patients with lowest NaE had hyponatraemia, hypokalaemia and secondary hyperaldosteronism. 5. Urinary sodium excretion from the unaffected kidney in unilateral renal artery stenosis correlated positively with arterial pressure, possibly reflecting the phenomenon of pressure-natriuresis. Patients subsequently responding least well to surgery excreted least sodium from the untouched kidney for a given arterial pressure. 6. The findings suggest important roles for arterial pressure in the regulation of sodium balance (predominant in renal artery stenosis), and for sodium balance in the regulation of arterial pressure (predominant in Conn's syndrome). The observations in essential hypertension are compatible either with an exact balance between these mechanisms or with the existence of some other mechanism raising blood pressure.

When to treat symptomless essential hypertension

1982 ◽  
Vol 20 (14) ◽  
pp. 53-54
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Renal Failure ◽  
Essential Hypertension ◽  
Drug Therapy ◽  
Arterial Pressure ◽  
Drug Treatment ◽  
Absolute Risk ◽  
Sodium Restriction ◽  
Cardiovascular Morbidity And Mortality

The risk of cardiovascular morbidity and mortality increases in proportion to the arterial pressure at all ages and in both sexes. Most authorities regard blood pressure above 140 mmHg systolic, 90 mmHg diastolic as abnormal. The absolute risk of raised blood pressure is greater in men than women, men being more liable to coronary disease. Raised blood pressure predisposes to stroke, cardiac ischaemia and heart failure, progressive renal failure, retinal lesions and malignant hypertension. Lowering the blood pressure reduces the risks of these complications. Non-drug measures which can help and are worth considering before drug therapy include regular meditation, sodium restriction, weight reduction, and cessation of cigarette smoking. The efficacy of these is however less well proven than that of drug treatment. This article discusses when drug treatment should be considered. Barritt1 presents the arguments in more detail.

scholarly journals Kidney Is Essential for Blood Pressure Modulation by Dietary Potassium

2020 ◽  
Vol 22 (10) ◽  
Author(s):  
Xiao-Tong Su ◽  
Chao-Ling Yang ◽  
David H. Ellison
Keyword(s):  
Blood Pressure ◽  
Potassium Concentration ◽  
Blood Pressure Reduction ◽  
Chloride Concentration ◽  
Plasma Potassium ◽  
Reduce Blood Pressure ◽  
Fluid Volume ◽  
Extracellular Potassium ◽  
High Potassium ◽  
Extracellular Potassium Concentration

Abstract Eating more potassium may reduce blood pressure and the occurrence of other cardiovascular diseases by actions on various systems, including the vasculature, the sympathetic nervous system, systemic metabolism, and body fluid volume. Among these, the kidney plays a major role in the potassium-rich diet–mediated blood pressure reduction. Purpose of Review To provide an overview of recent discoveries about the mechanisms by which a potassium-rich diet leads to natriuresis. Recent Findings Although the distal convoluted tubule (DCT) is a short part of the nephron that reabsorbs salt, via the sodium-chloride cotransporter (NCC), it is highly sensitive to changes in plasma potassium concentration. Activation or inhibition of NCC raises or lowers blood pressure. Recent work suggests that extracellular potassium concentration is sensed by the DCT via intracellular chloride concentration which regulates WNK kinases in the DCT. Summary High-potassium diet targets NCC in the DCT, resulting in natriuresis and fluid volume reduction, which are protective from hypertension and other cardiovascular problems.

Blood pressure and metabolic effects of 9α-fluorocorticosterone and 9α-fluorodeoxycorticosterone in sheep

1985 ◽  
Vol 104 (2) ◽  
pp. 291-294 ◽  
Author(s):  
B. A. Scoggins ◽  
J. P. Coghlan ◽  
D. A. Denton ◽  
P. J. McCarthy ◽  
R. T. Mason ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Urine Volume ◽  
Plasma Potassium ◽  
Metabolic Effect ◽  
Metabolic Effects

ABSTRACT 9α-Fluorocortisol has been postulated to have 'hypertensinogenic' as well as 'mineralocorticoid' and 'glucocorticoid' activity. The present study examined the blood pressure and metabolic effect in sheep of the structurally related steroids 9α-fluorodeoxycorticosterone (9α-FDOC) and 9α-fluorocorticosterone (9α-FB). Infusions of these fluorinated steroids at 0·63 and 0·67 mg/day respectively for 5 days produced falls in plasma potassium, but only 9α-FB increased urine volume. 9α-FDOC raised mean arterial pressure by 11 mmHg and 9α-FB raised it by 14 mmHg. Addition of a 9α-fluoro group appears to increase both 'mineralocorticoid' and 'hypertensinogenic' steroid potencies. J. Endocr. (1985) 104, 291–294

Plasma Noradrenaline Concentrations and Haemodynamics in the Early Stage of Essential Hypertension

1978 ◽  
Vol 55 (s4) ◽  
pp. 69s-71s ◽  
Author(s):  
Y. Miura ◽  
K. Kobayashi ◽  
H. Sakuma ◽  
H. Tomioka ◽  
M. Adachi ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Mean Arterial Pressure ◽  
Cardiac Index ◽  
Arterial Pressure ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Young Patients ◽  
Plasma Noradrenaline ◽  
Age Related ◽  
Wide Range

1. Plasma noradrenaline concentrations and haemodynamic status were simultaneously studied in young patients with uncomplicated essential hypertension and in age-matched normal controls. 2. Resting plasma noradrenaline in the controls tended to increase slightly, but progressively, with age. The hypertensive subjects had significantly higher plasma noradrenaline concentrations than those in the controls, but these values did not show any age-related variation. The response of plasma noradrenaline to the standing position tended to increase with age in the controls, whereas plasma noradrenaline in the hypertensive subjects showed a wide range of responses without any fixed relationship with age. 3. The cardiac index was significantly greater in the labile hypertensive subjects than in the controls, whereas total peripheral resistance was significantly greater in the sustained hypertensive subjects than in the labile patients and in the controls. Mean arterial pressure in these patients was closely related with the values of total peripheral resistance rather than with the cardiac index. 4. Of the patients with raised plasma noradrenaline 80% showed significantly increased values of either total peripheral resistance or cardiac index. Plasma noradrenaline was correlated significantly to total peripheral resistance, and marginally to mean arterial pressure. 5. These findings support the view that sympathetic nervous overactivity is an important factor underlying the haemodynamic findings in these patients.

Plasma Volume Decrease and Elevated Evans Blue Disappearance Rate in Essential Hypertension

1973 ◽  
Vol 45 (2) ◽  
pp. 173-181 ◽  
Author(s):  
Milos Ulrych
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Essential Hypertension ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Plasma Volume ◽  
Evans Blue ◽  
Disappearance Rate ◽  
The Mean ◽  
Volume Decrease

1. The disappearance rate of intravenously injected Evans Blue, plasma volume, cardiac output, and blood pressure were measured in seven normotensive and eighteen hypertensive subjects. 2. Plasma volume was found to be negatively correlated with the mean arterial pressure, Evans Blue disappearance rate and packed cell volume. 3. Faster disappearance rate of Evans Blue in hypertensive subjects may be due to an abnormality of mixing of the label or of the capillaries.

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