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Aldosterone Metabolic Clearance is Normal in Low-Renin Essential Hypertension

Department of Medicine, Baylor College of Medicine Houston, Texas 77025

Address reprint requests to: Dr. R. D. Brown, Mayo Clinic, Rochester, Minnesota 55901.

The possibility that an abnormality of aldosterone metabolism plays a role in the pathogenesis of low-renin essential hypertension was investigated. Normal subjects and patients with low-renin or normal-renin essential hypertension were evaluated while in balance, ingesting a diet providing 120 mEq sodium and 70 mEq potassium. Aldosterone metabolic clearances were determined by a constant infusion technique using tritiumlabeled aldosterone. Aldosterone secretion rates and plasma aldosterone concentrations were measured by radioimmunoassay.

Aldosterone metabolic clearance in normal subjects was 1422 ± 69 (mean ± SE) liters/24 hours. In patients with low-renin essential hypertension, aldosterone metabolic clearance was 1351 ± 61 liters/24 hours, and in patients with normal-renin essential hypertension, it was 1412 ± 66 liters/24 hours. These values were not significantly different from those of normal subjects.

Although aldosterone secretion rates in both groups of hypertensive patients were within the normal range, patients with low-renin essential hypertension, under the conditions of this study, had significantly higher secretion rates than patients with normal-renin essential hypertension.

We have concluded that the maintenance of plasma aldosterone in low-renin essential hypertension reflects sustained aldosterone secretion despite suppression of plasma renin activity, rather than reduced aldosterone metabolism. The maintenance of normal aldosterone secretion in low-renin essential hypertension appears to be inappropriate and is not explained by alterations of known regulatory mechanisms.

Supported in part by Baylor Clinical Research Center Grant RR 00 134.

Presented in part at the meeting of the American Federation for Clinical Research, New Orleans, 1975.

Received July 14, 1975.

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				J. R. MITCHELL, A. A. TAYLOR, J. L. POOL, C. R. LAKE, D. E. ROLLINS, and F. C. BARTTER Renin-Aldosterone Profiling in Hypertension Ann Intern Med, November 1, 1977; 87(5): 596 - 612. [Abstract] [PDF]