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Essential Hypertension: New Concepts About Mechanisms
- MOHINDER P. SAMBHI, M.D., Ph.D.;
- MILTON G. CRANE, M.D., Ph.D.; and
- JACQUES GENEST, M.D., F.A.C.P., F.R.C.P.
Abstract
Patients with benign essential hypertension in the early uncomplicated stage show several deviations from normal in their renal and adrenal hormonal systems. Levels of plasma aldosterone and progesterone and the secretion rate of 18-hydroxy-11-deoxycorticosterone are shown to be increased, and the metabolic clearance rate of aldosterone is shown to be decreased in these patients. Also, in vitro, the plasma, with added homologous renin, generated angiotensin at rates much higher than normal. Conflicting evidence is presented on plasma aldosterone measurements, including age-dependent decreases in plasma renin and aldosterone. The significance of these findings in pathogenesis of essential hypertension is discussed.
Article and Author Information
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▸An edited transcription of the Clinical Case Conference arranged by the Department of Medicine, UCLA School of Medicine, Los Angeles, California.
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The work reported by Dr. Milton G. Crane was supported by research grant HE04745, National Heart Institute; and contract 71-2283, National Institute of Child Health and Human Development, U.S. Public Health Service. Dr. Crane acknowledges the close collaboration of Dr. John J. Harris in this research and the technical assistance of Virginia Yeh, Dr. Russell Brown, Jim Purdom, and Barbara Witmer.
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The work reported by Dr. Mohinder P. Sambhi was supported by research grant HL15039, National Heart and Lung Institute, and by support from Sepulveda Veterans Administration Hospital. Dr. Sambhi acknowledges the essential collaboration of Drs. Peter Eggena and Jack Barrett and Mr. Charles Wiedeman.
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▸Requests for reprints should be addressed to Mohinder P. Sambhi, M.D., Division of Hypertension, Veterans Administration Hospital, 16111 Plummer St., Sepulveda, CA 91343.
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- Received May 2, 1973.
- Accepted May 29, 1973.
