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Rapid Cardiovascular Action of Aldosterone in Man¹

Institute of Clinical Pharmacology (M.W., B.M.W.S., M.C.), Faculty of Clinical Medicine Mannheim, University of Heidelberg, 68135 Mannheim, Germany; Medizinische Klinik (C.H.S., N.W., K.T.), Klinikum Innenstadt, University of Munich, 80336 Munich, Germany; and Department of Biostatistics (C.P.J.), Institute of Clinical Pharmacology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, 68135 Mannheim, Germany

Address all correspondence and requests for reprints to: Martin Wehling, M.D., Curt-Engelhorn-Professor of Medicine, Director of Institute of Clinical Pharmacology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer, 68135 Mannheim, Germany.

Rapid nongenomic in vitro effects of aldosterone have been demonstrated recently in cultured vascular smooth muscle and endothelial cells. But there is, as yet, little evidence for corresponding in vivo effects. The present study thus investigates the rapid nongenomic effects of aldosterone on human cardiovascular function. In a double-blind placebo-controlled randomized parallel trial on 17 patients with suspected coronary heart disease, the effect of 1 mg aldosterone iv on cardiovascular function was assessed during cardiac catheterization. Hemodynamic parameters (such as heart rate, left ventricular and atrial pressures, arterial pressures, vascular resistances, and cardiac output) were measured before and 3 and 10 min after administration of aldosterone or placebo. Significant changes were found for systemic vascular resistance, cardiac output, and cardiac index, compared with the placebo group (Wilcoxon test, P < 0.02–0.05). The effect of aldosterone dissipated within 10 min.

The results are in line with the in vitro data cited above and consistent with earlier findings on acute cardiovascular effects of aldosterone, which have now been confirmed and extended by contemporary techniques. The hypotheses of rapid nongenomic in vivo effects of aldosterone are further substantiated by this study.

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