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.

Adult↗

PubMed1979

Captopril in hypertension with renal artery stenosis and in intractable hypertension; acute and chronic changes in circulating concentrations of renin, angiotensins I and II and aldosterone, and in body composition.

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Adolescent↗

PubMed1979

Size of lipoproteins in intestinal lympho of sheep and suckling lambs.

The relative importance of chylomicrons (Sf greater than 400) and very low density lipoproteins (Sf 20--400) in transporting lipids in lymph was investigated in surgically prepared adult sheep and pre-ruminant lambs fed low fat diets or infused intraduodenally with corn oil. The concentration of triacylglycerol in the intestinal lymph of sheep and lambs was increased from 520 and 925 mg/100 ml to 2326 and 2367 mg/100 ml respectively when corn oil was infused into the duodenum and the ratio of triacylglycerol to phospholipid changed from 3.7 and 5.5 to 9.5 and 9.7 respectively. The flow of lymph also increased. Electron microscopy and analytical and preparative ultracentrifugation showed that lymph lipoproteins from sheep and lambs fed low fat diets consisted mainly of lipoproteins 50 nm in diameter and that very low density lipoproteins (Sf 20--400) contirbuted up to 75% of the Sf greater than 20 lipoproteins. There were no lipoproteins with diameters above 150 nm. Infusion of corn oil into the duodenum of sheep and lambs increased the diameters of lymph lipoproteins. Most were 80--100 nm in diameter but substantial numbers above 150 and up to 400 mn were observed. The maximum contribution of very low density lipoproteins (Sf 20--400) to lipoproteins of Sf greater than 20 was 27--30%. The above findings demonstrate that the size of intestinal lymph lipoprotein particles increases with the amount of lipid absorbed from the small intestines and that the transport of lymph lipids, in ruminants, is similar to that previously found in rats, rabbits and man.

Animals↗

PubMed1979

Blood pressure reduction by incremental infusion of labetalol in patients with severe hypertension.

1. Labetalol was given by incremental intravenous infusion to nineteen severely hypertensive patients, of whom nine were refractory to previous oral antihypertensive therapy. 2. Smooth reduction of arterial pressure was achieved in twelve subjects; one remained resistant to labetalol up to 160 mg/h; a sudden fall in pressure occurred in the remaining six. No serious complications were encountered. Blood pressure control was accompanied by slight byt significant reduction in heart rate and in plasma angiotensin II and aldosterone concentrations. 3. The administration of labetalol in this way appears to be a useful technique in patients requiring rapid reduction of arterial pressure, although close and continuous supervision is necessary.

Adolescent↗

PubMed1979

Suppression of plasma ACTH concentration by angiotensin II infusion in normal humans and in a subject with a steroid 17 alpha-hydroxylase defect.

Six healthy subjects were infused with angiotensin II and plasma concentrations of angiotensin, ACTH and cortisol were measured before, during and after the infusion. In all cases the plasma ACTH concentration fell as plasma angiotensin increased and rose again, sometimes to higher than basal levels, when the angiotensin infusion was terminated. These effects were most marked at the highest rate of infusion (8 pmol/kg/min) and, at the lower rates (2 and 4 pmol/kg/min), there was some recovery of ACTH levels during the infusion period in some subjects. Plasma ACTH concentrations also fell when angiotensin was infused into a patient with high ACTH levels due to a steroid 17 alpha-hydroxylation defect. The inhibition of ACTH secretion is not due to a rise in plasma cortisol operating a negative feedback inhibition. It could be a direct effect of the infused angiotensin on the brain-hypothalamus-pituitary complex or an effect on the metabolism of ACTH.

Adrenal Hyperplasia, Congenital↗

PubMed1979

Effect of the angiotensin II antagonist saralasin on plasma aldosterone concentration and on blood pressure before and during sodium depletion in normal subjects.

The effect of the angiotensin II antagonist saralasin on plasma aldosterone, plasma angiotensin II and blood pressure was studied in six normal supine subjects both before and during sodium depletion. Before sodium depletion, infusion of saralasin produced no consistent changes; during sodium depletion, infusion of the angiotensin antagonist caused a fall in plasma aldosterone and an increase in plasma angiotensin II in each subject. It is concluded that angiotensin II plays a major part in stimulating aldosterone secretion during sodium depletion in man.

Adult↗

PubMed1979