Effects of ACTH on Plasma Levels of Adrenal Steroids in Essential Hypertension

Abstract

SynopsisPlasma concentrations of progesterone (P), deoxycorticosterone (DOC), 17-hydroxyprogesterone (17-OH P), corticosterone (B), deoxycortisol (S), cortisol (F) and aldosterone (A) in 8 control subjects (mean age: 40.5 years) and 10 patients with essential hypertension (EH) (mean age: 48.5 years) were determined before, 4 and 8 hours after an infusion of ACTH at a rate of 25 units per 8 hours.Secretion rates (SR) of 18-hydroxy-11-deoxycorticosterone (18-OH DOC) were measured 24 hours before and again on the day of ACTH infusion.All subjects were studied on the fourth day of a diet containing 135 mEq of sodium and 90 mEq of potassium.There was no statistically significant difference between 8 control subjects and 10 patients with FH in the 7 plasma steroid levels and the SR of 18-OH DOC before ACTH infusion.The mean plasma presponse to ACTH was slightly lower in controls than in patients with EH, while that of 17-OH p(in male subjects) was slightly higher. The mean plasma B response was significantly lower atter 4 nours or At., in infusion (p<0.01), while that of DOC was significantly higher after 8 hours of ACTH infusion (p<0.05) in patients with EH. The mean plasma S rose significantly more in patients with EH (p<0.025) at 4 and 8 hours after ACTH infusion.The mean plasma F response to ACTH infusion was slightly lower in patients with EH than in controls.The mean response of 18-OH DOC SR to ACTH infusion was slightly higher in patients with EH than in controls.The mean plasma A response was significantly higher in patients with EH than in controls 4 (p<0.05) and 8 hours (p<0.001) after an ACTH infusion.These results could be explained in part by abnormalities in the 17-and 11-hydroxylase systems, and that the abnormality in 11-hydroxylation was more pronounced than that in the 17-position.Furthermore, we suspect that the sensitivity of adrenal aldosterone to ACTH might be increased or another accelerated pathway to aldosterone biosynthesis might exist in patients with EH.