Effects of ACTH and Cortisol Administration on Blood Pressure, Electrolyte Metabolism, Atrial Natriuretic Peptide and Renal Function in Normal Man

Connell, John; Whitworth, Judith A.; Davies, David; Lever, A. F.; Richards, A. N.; Fraser, Robert

doi:10.1097/00004872-198708000-00007

Cited by 166 publications

(137 citation statements)

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“…26 Considerable evidence implicates the pituitary-adrenal axis and glucocorticoids as regulators of systemic BP in the preterm infant. [27][28][29][30][31][32] Glucocorticoids influence BP through several mechanisms: (1) increasing plasma and extracellular fluid by shifting fluid from the intracellular compartment, 29,30 (2) inducing the synthesis of angiotensinogen in hepatic cells, 33 (3) inhibiting the synthesis of vasodilator prostaglandins, 34,35 (4) increasing vascular responsiveness to ␣ adrenergic amines, 36,37 and (5) inhibiting nitric oxide production. 38 Preterm infants with hypotension that is resistant to vasopressors and volume expanders respond to relatively small doses of hydrocortisone.…”

Section: Discussionmentioning

confidence: 99%

Effects of Antenatal Corticosteroids on Blood Pressure in Very Low Birth Weight Infants During the First 24 Hours of Life

et al. 1999

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Section: Discussionmentioning

confidence: 99%

Effects of Antenatal Corticosteroids on Blood Pressure in Very Low Birth Weight Infants During the First 24 Hours of Life

et al. 1999

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“…From a physiopathological point of view these findings are sound (21 -29). Although acute corticosteroid administration in normal men does not modify creatinine clearance, these data do not reflect hemodynamic changes of chronic endogenous hypercortisolism that can influence (deteriorate) GFR (30). Indeed, chronic hypercortisolism influences vascular tone and may permanently alter vessel remodeling.…”

Section: Discussionmentioning

confidence: 79%

Glomerular filtration rate in patients with Cushing’s disease: a matched case–control study

Haentjens

Meirleir²,

Abs³

et al. 2005

eur j endocrinol

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Background: Patients with Cushing's disease have a high prevalence of atherosclerosis and maintain an increased cardiovascular risk even after cure of the disease. However, the impact of Cushing's disease on renal function remains to be quantified. Objectives: To evaluate glomerular filtration rate (GFR) and to identify predictors of GFR in patients with Cushing's disease. Design and methods: We conducted a matched case -control study: 18 patients with active or cured Cushing's disease were compared with healthy population controls matched for age and sex. The main outcome measures were GFR and micro-albuminuria. Results: Patients with Cushing's disease had a lower GFR, as measured by 24-h creatinine clearance (79 versus 95 ml/min per 1.73 m 2 , P ¼ 0.005) and estimated by the MDRD 2 formula (75 versus 88 ml/min per 1.73 m 2 , P ¼ 0.008). Multiple regression analyses indicated that disease duration was the strongest predictor for a worse GFR. The prevalence of micro-albuminuria was low (5.5% in both groups). Conclusions: Patients with Cushing's disease have a decreased GFR. Even if they are cured, close follow-up with strict control of cardiovascular risk factors and monitoring of GFR seems mandatory. Furthermore, the dosage of certain drugs should be adapted to the individual GFR.

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“…2 Second, exogenous cortisol administration has been consistently shown to result in an increase in blood pressure. [3][4][5][6] Third, glucocorticoids are being increasingly implicated in the regulation of blood pressure at several sites, including the vasculature, the kidneys and the brain. 1 Fourth, higher cortisol concentrations have been observed in normotensive young individuals with a positive family history of hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Furthermore, experimental infusion of cortisol in normotensive men has been repeatedly shown to result in an increase in blood pressure. [3][4][5][6] However, the evidence that suggests that cortisol excess is a feature of population hypertension is less overwhelming. Most of the relevant epidemiological studies are small and have samples approximately p500, and not all have found positive associations between cortisol and high blood pressure.…”

Section: Introductionmentioning

confidence: 99%

Cortisol, dehydroepiandrosterone sulphate, their ratio and hypertension: evidence of associations in male veterans from the Vietnam Experience Study

et al. 2011

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Although clinical observations implicate cortisol in hypertension, the epidemiological evidence is less compelling. Little is known about the relationship between dehydroepiandrosterone sulphate (DHEAS) and hypertension, and nothing about the association with the cortisol:DHEAS ratio. The present analyses of data obtained from Vietnamera US veterans examined the associations between cortisol, DHEAS, their ratio and hypertension. Participants were 4180 male veterans. From military files, telephone interviews and a medical examination, sociodemographic and health data were collected. At medical examination, a fasted morning blood sample was collected to assay serum cortisol and DHEAS, blood pressure measured and body mass index (BMI) determined. Hypertension was defined by having one of the following: a reported physician diagnosis, taking antihypertensive medication, an average systolic blood pressure X140 mm Hg and an average diastolic blood pressure X90 mm Hg. Cortisol and the cortisol:DHEAS ratio were positively associated with hypertension (Po0.001), whereas DHEAS was negatively associated; the latter relationship was attenuated to non-significance (P ¼ 0.06) in models that adjusted for age, sociodemographics, place of service, health behaviours and BMI. The present analyses provide confirmation of a positive association between cortisol and the cortisol:DHEAS ratio and population hypertension.

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Effects of ACTH and Cortisol Administration on Blood Pressure, Electrolyte Metabolism, Atrial Natriuretic Peptide and Renal Function in Normal Man

Cited by 166 publications

References 0 publications

Effects of Antenatal Corticosteroids on Blood Pressure in Very Low Birth Weight Infants During the First 24 Hours of Life

Effects of Antenatal Corticosteroids on Blood Pressure in Very Low Birth Weight Infants During the First 24 Hours of Life

Glomerular filtration rate in patients with Cushing’s disease: a matched case–control study

Cortisol, dehydroepiandrosterone sulphate, their ratio and hypertension: evidence of associations in male veterans from the Vietnam Experience Study

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