[Pathogenesis and treatment of arterial hypertension in hypothyroidism patients].
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Biomedical subjects
Publications and source records attributed to F M Egart.
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It appeared that urinary aldosterone excretion was increased in 23 of 35 patients with a syndrome of idiopathic edema. The plasma renin activity failed to differ from the norm; consequently it can be supposed that the renin-angiotensin system played no significant role in the mechanism of hyperaldosteronism development in this form of pathology. A negative sodium balance was revealed in some of the patients with an edema syndrome and hyperaldosteronism.
Prolactin and aldosterone secretion and renin activity in the plasma were measured in the course of thyroliberin (TRH) test in women with various endocrine diseases, both connected with the water-salt metabolism disturbances and without these--with the idiopathic edemas (n = 11), hypothyrosis (n = 16), Stein-Leventhal'syndrome (n = 6), and obesity (n = 8). A reciprocal relationship between prolactin concentrations (a drastic elevation) and aldosterone levels (lowered) were revealed, as were universal responses of both the hormones to TRH administration in patients with various conditions. The authors come to a conclusion on the absence of a stimulating effect of prolactin on aldosterone secretion and plasma renin activity. They suggest an indirect contribution of prolactin to the regulation of the renin-aldosterone system, probably via dopaminergic mechanisms.
Timely diagnosis of hypothyrosis was noted in 34% of patients only. Considerable difficulties in the diagnosis of disease were associated with an atypical course of disease in a number of patients. The authors discuss some problems of a clinical picture of hypothyrosis with arterial hypertension, sympatico-adrenal crises, polyserositis, pituitary adenoma, amenorrhea-lactorrhea, premature puberty in boys; they also discuss pathogenesis of sexual advancement of a number of pubertal features in Van Wyk-Grambooh syndrome. Hennes-Ross syndrome was identified as a separate entity.
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The state of renal excretion of glycosaminoglycans (GAG) was investigated in 15 patients with hypothyrosis of various degree of gravity before and during thyroid therapy. A raised level of GAG excretion with urine reflecting excessive GAG tissue accumulation was revealed. A degree of elevation was unrelated to a gravity of disease and grew with a period of disease. Thyroid therapy considerably increased GAG renal excretion, particularly in patients with a longer period of disease. A GAG level in daily urine can be used as an additional diagnostic criterion in hypothyrosis and the time course of GAG can serve for assessment of therapeutic efficacy.
A study was made of aldosterone (A) level and plasma renin activity (PRA) in 47 patients with hypothyrosis of various degree of severity prior to and during therapy with thyroid drugs. A normal basal A level in the blood plasma was noted, in some patients it was raised or lowered. The following tendency was revealed during therapy with thyroid drugs: in patients with lowered A and PRA levels a rise of these levels was noted during treatment, in raised levels a significant drop was noted. Normal A and PRA basal levels (in most of the patients) showed in the process of treatment diverse tendencies: toward a decrease in the A level and a rise of the PRA level within normal range. The results obtained indicated independent effect of thyroid hormones on A and PRA synthesis. In case of low level of endogenous thyroid hormones as well as exposure to exogenous thyroid hormones changes in the A level were not directly controlled by PRA.