Acute and chronic effects of the angiotensin-converting enzyme inhibitor captopril in severe hypertension.
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Aldosterone↗
Biomedical subjects
S Wollnik
Publications and source records attributed to S Wollnik.
[Intracellular sodium and calcium as a genetic marker in essential hypertension].
In 33 normotensive probands with a familial disposition to hypertension and in 18 normotensives without a family history of hypertension, aged 15 to 24 years, intracellular Na+ and Ca2+ activity in red blood cells was determined by ion-selective electrodes. The activities represent the free, i.e. unbound intracellular fraction of each ion. In the group with a family history of hypertension the mean intracellular Na+ activity was 9.74 +/- 1.43 mmol/l and clearly exceeded that in the group without predisposition to hypertension, which was 7.74 +/- 1.06 mmol/l. Even larger differences were found in mean intracellular Ca2+ activity (9.54 +/- 9.56 mumol/l in the group with familial disposition and 1.87 +/- 3.47 mumol/l in the control group). However, due to the relatively wide range of the values, especially with respect to the Ca2+ activities in probands with familial disposition to hypertension, the values from the two groups overlapped. The results suggest that elevation of intracellular Na+ and Ca2+ activity may be evidence for a genetically determined later development of hypertension.
Adolescent↗
[Renin-angiotensin-aldosterone system in essential hypertension. Inappropriately high plasma aldosterone in young patients with severe hypertension and in older hypertensives].
Both in male (n = 353) and in female patients (n = 211) with essential hypertension supine (basal) plasma renin activity showed an age-dependent significant decrease whereas plasma aldosterone remained almost unchanged in women or was even slightly increased with age in men. In younger hypertensives (15-34 years) a significant inverse correlation between plasma renin activity and mean arterial blood pressure could be observed. On the other hand, middle-aged men (35-50 years) showed a positive relationship between renin and blood pressure whereas in females of the same age group no correlation between these two parameters was found. In older patients (greater than 50 years) of both sexes a positive correlation between renin activity and mean arterial blood pressure was obtained. In all age-groups and in both sexes there was either no correlation, or only a weak (positive) one, between plasma aldosterone and mean arterial blood pressure. These findings suggest that in essential hypertension renin secretion is regulated mainly by blood pressure. The observed sex and age-related differences may be due to changes in the renovascular system. The inappropriately high plasma aldosterone concentrations (compared to the relatively low renin levels) in younger hypertensives with severe hypertension, and in the older population, document disturbed aldosterone secretion which probably contributes to the elevated blood pressure in these patients.
Acute Disease↗
Lateralization procedures in primary aldosteronism.
The diagnostic validity of adrenal isotopic scanning, adrenal venous aldosterone, adrenal phlebography and computed abdominal tomography (CT) was studied in 44 patients with primary aldosteronism. In all patients the diagnosis was confirmed by surgery (unilateral adrenal adenoma n = 32, bilateral adrenal hyperplasia n = 12). Both adrenal scintiscan, adrenal venous aldosterone and CT allowed in a comparable high percentage of patients (71%0 the exact classification of the adrenal lesion(s), whereas adrenal phlebography could distinguish adenoma from hyperplasia in 57%. Marked differences between the lateralization procedures, however, were observed in predicting incorrect preoperative indentification: adrenal scintiscan 29%, adrenal venous aldosterone 3%, adrenal veno-graphy 6% and CT 0%. Finally, the percentage of patients in whom no differentiation between the two main subgroups of primary aldosteronism could be obtain varied between 0% with adrenal isotopic scanning and 37% with adrenal phlebography (CT 29% and adrenal venous aldosterone 26%). Both scintiscan and adrenal venous aldosterone were not improved by the administration of dexamethasone. Our findings document that adrenal venous aldosterone determinations, adrenal isotopic scanning and computed tomography are equally valid in differentiating unilateral adenoma from bilateral adrenal hyperplasia in primary aldosteronism. However, adrenal scintiscan is hampered by a relative high percentage of incorrect results independant whether dexamethasone was used or not. Contrary, adrenal venous aldosterone and computed tomography seemed to have no or only a minor risk in assuming an incorrect classification of the adrenal lesion(s).
Adenoma↗