Vasoactive Substances in Hypertensive Disorders

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We have studied on the role of vasoactive substances in pathogenesis of hypertension in man. The results can be summarized as follows: Renin-Angiotensin-Aldosterone RAA System RAA system is not elevated in the majority of patients with essential hypertension. It is activated in patients with renovascular hypertension, and with hypertension due to toxemia of pregnancy. In primary aldosteronism, a characteristic dissociation is observed between aldosterone secretion rate and plasma renin activity; an increase in the former in the face of a decrease in the latter. Catecholamines Fifteen patients with pheochromocytoma have been studied, and a marked increase in excretion of catecholamines or their metabolites have been confirmed in all the cases. Patients with essential hypertension showed no difference in catecholamine excretion or its metabolic pattern from control subjects. In these patients, however, responses of blood pressure to vasopressor substances(noradrenaline, angiotensin)as well as vasodepressor substance(eledoisin)are excessive when compared with controls. When their blood pressure is lowered by eledoisin infusion, the sympathetic response, which is normally observed in controls and is reflected on an increased excretion of noradrenaline in urine, does not occur in them. It is likely that the counter-regulation of the sympathetic nervous system against the effects of introduced pressor or depressor substance is deficient in hypertensive patients. Kallikrein-Kinin System There is no difference in urinary excretion of this system, kallikrein and kinin, between hypertensive and control groups. Blood kinin levels are also normal in primary hypertension. Arneil Factor This pressor factor is detectable in all the subjects tested. The estimated values tend to be high in hypertensive patients, but considerable overlap with controls is also observed. The factor may be aphysiological principle in maintenance of blood pressure. More detailed study is now under progress.

Vasoactive Substances in Hypertensive Disorders

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