高血圧症とアルドステロン

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The purpose of this study was to examine the changes of urinary aldosterone excretion on sodium deprivation. Sixteen cases of essential hypertension, 7 cases of renal disease, 2 cases of primary aldosteronism, a case of Cushing's disease and 4 cases of normal subjects were studied.<BR>The urinary aldosterone excretion increased in all cases to maximum levels between the 2nd and the 7th day after the beginning of sodium deprivation and decreased gradually to the value on normal sodium intake. It was suspected that these changes were caused by the reduction of extracellular fluid volume. There were no significant increase in urinary output of aldosterone and a significant fall of the blood pressure on sodium deprivation in severe hypertensive subjects. But slight hypertensive subjects responded to a low sodium diet with an increase in urinary aldosterone excretion as well as normal subjects. It was observed that the blood pressure was stable upon sodium deprivation in such patients. It was suggestive that the difference of increasing rate of urinary aldosterone excretion between severe and slight hypertensive patients depend upon the pathohistologic changes of the adrenals in arterial hypertensive patients, and aldosterone acted on the maintenance of arterial blood-pressure. These changes of urinary aldosterone on sodium deprivation were independent of serum electrolytes and urinary potassium excretion, but was regularly accompanied by falls in sodium excretion and sodium to potassium ratio in urine. In primary aldosteronism and Cushing's disease with hypopotassemia, the falls of urinary potassium excretion and the rises of serum potassium were observed on sodium deprivation.<BR>The hypothesis was advanced that the low-sodium diet exerted its beneficial effect in the hypertensive patients except patients with severe renal damage by causing a fall in blood pressure and an improvement in the distribution of body water and electrolytes.
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高血圧症とアルドステロン

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