The substitutive role of ACTH in supporting aldosterone response to head-up tilt during acute renin suppression in patients with essential hypertension

Alberto Morganti, Jean E. Sealey, Jorge A. Lopez-Ovejero, Thomas G. Pickering, John H. Laragh

Research output: Contribution to journalArticlepeer-review

Abstract

The relatire contribution of the renin-angiotensin system, adenocorticotrophic hormone (ACTH) and plasma electrolytes in the response of plasma aldosterone to 30 minutes of 65° bead-up tilt was assessed in 10 essential hypertensire patients. Studies were carried out before and during acute blockade of renin release by propranolol, ACTH suppression by dexamethasone and combined renin and ACTH blockade. In control studies orthostasis induced significant increases only in plasma renin activity and aldosterone. In contrast, when the renin response to tilt was acutely suppressed by propranolol administration, the aldosterone response was nonetheless maintained but now appeared to be under ACTH control, since concurrent increases In cortisol were observed. During ACTH suppression aldosterone increased during tilt and so did renin. However, during combined ACTH and renin blockade aldosterone failed to increase during tilt. These studies suggest that the aldosterone secretory response to head-up tilt is normally mediated by the renin-angiotensin system but, when the renin response is suppressed, an ACTH response is elicited which assumes a backup role. However, when these two systems are blocked other factors appear unable to respond during tilt to support a normal aldosterone response.

Original languageEnglish
Pages (from-to)130-135
Number of pages6
JournalHypertension
Volume1
Issue number2
Publication statusPublished - 1979

Keywords

  • Adenocorticotropbic hormone
  • Aldosterone response
  • Bead-up tilt
  • Essential hypertension
  • Renin suppression
  • Renin-angiotensin system

ASJC Scopus subject areas

  • Internal Medicine

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