17-ketosteroids and Hypertension

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Adult; Age Factors; Androgens; Animals; Child; Estrogens; Female; Feminization; Gynecomastia; Humans; Hypertension; Male; Mastectomy; Middle Aged; Obesity; Swine; Varicocele

Topics: 17-Ketosteroids; Addison Disease; Adolescent; Adrenal Glands; Adrenal Insufficiency; Adult; Aldosterone; Androgens; Child; Cushing Syndrome; Dehydroepiandrosterone; Desoxycorticosterone; Dexamethasone; Female; Humans; Hydrocortisone; Hyperaldosteronism; Hypertension; Infant; Male; Pituitary-Adrenal Function Tests; Renin; Spironolactone; Virilism

Topics: 17-Ketosteroids; Adolescent; Adrenal Gland Diseases; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Child; Child, Preschool; Dehydration; Female; Glucocorticoids; Humans; Hyperplasia; Hypertension; Infant; Infant, Newborn; Male; Mixed Function Oxygenases; Oxidoreductases; Pylorus; Virilism; Vomiting; Water-Electrolyte Balance

The morning surge in blood pressure (BP) is related to the morning occurrence of lethal cardiovascular events. We tested the hypothesis that salt intake may be associated with the morning surge in BP in essential hypertension. Seventy-six patients were admitted and placed on a low salt diet (2 g/day) for 7 days followed by a high salt diet (20-23 g/day) for another 7 days. At the end of each salt diet, 24-h ambulatory BP and heart rate monitorings and head-up tilt (HUT) test were performed. Patients whose average mean BP (MBP) was increased by more than 10% by salt loading were assigned to the salt-sensitive (SS) group (n = 37); the remaining patients, whose MBP was increased by less than 10%, were assigned to the non-salt-sensitive (NSS) group (n = 39). The increase in ambulatory MBP during 6.30-8.00 am above the baseline (2.00-4.00 am) was significantly enhanced by salt loading in the NSS group (P < 0.05), but not in the SS group. The coefficient of variation of 24-h MBP and heart rate was increased by salt loading only in the NSS group. The significant elevation of plasma noradrenaline concentration after awakening, which was noted during the low salt diet period, was unchanged during the high salt diet period in the NSS group, but abolished in the SS group. Salt loading enhanced HUT-induced decrease in systolic BP without affecting the heart rate response only in the NSS group. We conclude that the morning surge in BP is enhanced by salt loading in the NSS type of essential hyper- tension, presumably by the excessive activation of the sympathetic nervous system. Journal of Human Hypertension (2000) 14, 57-64.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Aldosterone; Baroreflex; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Catecholamines; Circadian Rhythm; Female; Heart Rate; Humans; Hypertension; Male; Middle Aged; Renin; Sodium, Dietary; Sympathetic Nervous System; Tilt-Table Test

Here we report a case of a renin-producing adrenocortical carcinoma. A 57-year-old woman was referred to our hospital complaining of thirst and generalized muscle weakness. She was diagnosed as being hypertensive and diabetic with associated hypokalemia and she had a hard elastic mass with a diameter of 10 cm on the left side of her neck. An abdominal computed tomography scan revealed a suprarenal mass on the left side (8.5 x 8 x 6.5 cm). Endocrinological examination demonstrated a marked elevation in the patient's serum glucocorticoid and sex steroid hormones as well as plasma renin activity. Histological examination of a sample taken from the neck mass revealed a metastasis from an adrenal carcinoma, which was stained positively with antibodies against cytochrome P450 and renin, establishing the diagnosis of a renin-producing adrenocortical carcinoma. Trilostane was effective in reducing serum cortisol levels, but mitotane was ineffective.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; 3-Hydroxysteroid Dehydrogenases; Adrenal Cortex Neoplasms; Biopsy, Needle; Catecholamines; Cytochrome P-450 Enzyme System; Dihydrotestosterone; Enzyme Inhibitors; Female; Glucocorticoids; Gonadal Steroid Hormones; Humans; Hydrocortisone; Hypertension; Hypokalemia; Middle Aged; Mitotane; Muscle Weakness; Neoplasm Metastasis; Renin; Thirst; Tomography, X-Ray Computed

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Neoplasms; Age Factors; Child; Child, Preschool; Cushing Syndrome; Dehydroepiandrosterone; Environmental Pollutants; Female; Humans; Hypertension; Infant; Infant, Newborn; Male; Prognosis; Retrospective Studies; Sex Factors; Treatment Outcome; Virilism

Operative management of pheochromocytomas dictates resection of the involved adrenal and exploration-resection of the contralateral gland if enlarged. We describe an exception to this rule.. We report the largest series of patients with adrenocorticotropic hormone (ACTH)-secreting pheochromocytomas and review the world literature.. Four patients presented with findings of adrenocorticoid and catecholamine excess, as well as elevated levels of plasma ACTH, urinary metanephrines, and urinary free cortisol. Abdominal computed tomography scans revealed bilateral adrenal hyperplasia, and magnetic resonance imaging scans showed a unilateral adrenal mass with a bright T2 signal suggesting a pheochromocytoma. Two patients underwent adrenal venous sampling localizing ACTH secretion to the pheochromocytoma. All underwent unilateral adrenalectomy for a benign tumor without morbidity or death, leaving the contralateral hyperplastic adrenal in situ. After operation all patients experienced normalization of their levels of plasma ACTH, urinary metanephrines, and urinary free cortisol with resolution of symptoms. Combining our series with previously reported cases of ACTH-secreting pheochromocytomas, almost all are benign (20 of 21), in contrast to most ACTH-secreting tumors.. ACTH-secreting pheochromocytomas are the exception to the rule; unilateral adrenalectomy is curative and the contralateral hyperplastic adrenal can be preserved. This approach results in resolution of both syndromes of hormone excess and preserves long-term adrenal function.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Catecholamines; Female; Humans; Hydrocortisone; Hypertension; Magnetic Resonance Imaging; Male; Middle Aged; Pheochromocytoma; Tomography, X-Ray Computed

Adrenal tumors showing no clinical manifestations (incidentaloma) are frequently encountered during imaging analysis upon routine examinations. These tumors are sometimes associated with hypertension and/or diabetes mellitus (DM). We have examined six cases of incidentalomas with these symptoms in this study. All patients underwent endocrinological evaluation by measuring plasma cortisol and aldosterone levels to assess adrenocortical function. The levels of urinary 17-hydroxysteroids, 17-ketosteroids and catecholamines were also measured. Imaging analysis were performed by using 131I-adosterol scintigraphy, computed tomography and magnetic resonance imaging. Whereas one case was diagnosed as having an adrenal adenoma without the examination of a surgical specimen, other cases underwent surgical removal of the tumor, and final diagnoses were made by pathohistological examination of the tumors. Three cases were diagnosed as having adrenocortical adenomas (one was functioning and others were non-functioning) and one case was diagnosed as having a functional adrenocortical carcinoma. Adenomas were found to produce either non-functional steroids or a small amount of functional steroid hormones. The adenoma patients all suffered hypertension, whereas one of the adenoma patients and the carcinoma patient showed signs of DM. By contrast, of the six cases, one case was diagnosed as having an adrenal cyst, and one case was diagnosed with myelolipoma. Although these two cases suffered DM and hypertension, respectively, it seemed to be unlikely that these clinical symptoms were caused by the adrenal disease. Thus, the present analysis of the six incidentaloma patients suggests that once an adrenal incidentaloma patient with hypertension and/or DM is found, both endocrinological and imaging examinations are necessary to determine the indication of surgical treatment. This analysis supports the present consensus that non-functional adenomas whose sizes are 3cm or less and whose sizes do not change at any reevaluation period, as well as adrenal cysts and myelolipoma should not be surgically removed.

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Aged; Aldosterone; Carcinoma; Catecholamines; Cushing Syndrome; Diabetes Mellitus; Female; Humans; Hydrocortisone; Hydroxysteroids; Hypertension; Male; Middle Aged

The study was undertaken to examine 30 healthy males and 67 patients with arterial hypertension. The author studied urinary excretion of 17-KS and blood levels of cortisol and adrenocorticotropic hormone before and after emotional stress induced by the "hour/compass" test. It was found that due to the stress, the release of the metabolites corticosteroids was higher in intensity than changes in blood concentrations of cortisol and adrenocorticotropic hormone in borderline hypertension and Stage I hypertensive disease, whereas these parameters were in an inverse ratio in Stage II hypertensive disease. Such changes occurred in patients with secondary hypertension. The ratio should be used as a diagnostic test.

Topics: 17-Ketosteroids; Adaptation, Physiological; Adrenocorticotropic Hormone; Blood Pressure; Humans; Hydrocortisone; Hypertension; Hypothalamo-Hypophyseal System; Male; Pituitary-Adrenal System; Stress, Psychological

A patient with essential hypertension receiving the oral administration of acebutolol, a beta 1-selective adrenergic blocker, showed a marked increase in urinary 17-ketosteroid (17-KS) excretion determined by Zimmermann's method. Since the normal concentration of each fraction of 17-KS was found in this case by gas chromatography, the possibility of an abnormality in steroid metabolism could be excluded from the mechanism of the increase in the measured value for urinary 17-KS. In the urine samples from patients treated with acebutolol, acebutolol and acetylated acebutolol, a main metabolite of acebutolol, were found equally among them. Moreover, acebutolol or acetylated acebutolol resulted in a dose-dependent increase in 17-KS by Zimmermann's method in phosphate buffered saline or in a urine sample. However, the other beta-blockers, such as propranolol, alprenolol and oxprenolol did not show any effect on the determined value for urinary 17-KS. Thus it was concluded that the activated methylene group of acebutolol and acetylated acebutolol may interfere with the measured values obtained by Zimmermann's method.

Topics: 17-Ketosteroids; Acebutolol; Drug Interactions; Female; Humans; Hypertension; Methods; Middle Aged

Topics: 17-Ketosteroids; Adrenal Cortex; Aldosterone; Humans; Hydrocortisone; Hypertension; Renin; Tomography, X-Ray Computed

ACTH-stimulation adrenal imaging (ACTH-I) was performed in 14 patients after baseline imaging (B-I) was performed. In six patients with no adrenal diseases in whom the findings of B-I were equivocal, morphologic normality of the adrenals was confirmed by ACTH-I because of increased adrenal uptake of radioiodocholesterol. In three patients with cortisol-producing tumors, visualization of contralateral glands by ACTH-I provided indirect evidence for autonomous cortisol secretion of the tumors. In three patients with pheochromocytoma or cyst, ACTH-I increased adjacent cortical radioactivity to more clearly delineate the lesions. In two patients with primary adrenocortical insufficiency, exogenous ACTH had no effect on adrenal uptake of the tracer. Correlation was observed between response of the adrenal net counts and urinary excretion of 17-OHCS and 17-KS. ACTH-I is useful when B-I does not provide sufficient diagnostic information or further information is needed due to low or absent radioiodocholesterol uptake by the adrenal gland(s).

Topics: 17-Ketosteroids; 19-Iodocholesterol; Addison Disease; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Aged; Cholesterol; Female; Humans; Hypertension; Male; Middle Aged; Pituitary-Adrenal Function Tests; Radionuclide Imaging

Topics: 17-Ketosteroids; Adrenal Glands; Adult; Blood Pressure; Epinephrine; Heart Rate; Humans; Hydrocortisone; Hypertension; Male; Middle Aged; Norepinephrine; Stress, Psychological

A study of the adrenal function in patients with essential hypertension was performed using gas-liquid chromatography to separate and measure the daily urinary excretion of individual 17-ketosteroids, pregnanediol and pregnanetriol in basal conditions and after a dexamethasone suppression test. The purpose of the study was to detect alterations of adrenal function possibly indicative of some role of the adrenal cortex in the pathogenesis of hypertension. The results showed normal urinary levels of 17-ketosteroids, pregnanediol and pregnanetriol in most patients. Higher values were observed in the remaining cases. Dexamethasone suppression tests confirmed that steroid excess in these patients was of adrenal origin.

Topics: 17-Ketosteroids; Adrenal Glands; Adult; Aged; Female; Humans; Hypertension; Middle Aged; Pregnanediol; Pregnanetriol

Two patients with low renin hypertension showing an increased urinary excretion with 17-KS, with normal level of plasma deoxycorticosterone and no signs of virilization were reported. Dexamethasone induced reduction in blood pressure and elevation of serum K, in spite of acceleration of the renin-angiotensin-aldosterone system. Thus, it has been inferred that the hypertension was not associated with adrenogenital syndrome but was due to excessive production of an unknown mineralocorticoid.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Aldosterone; Blood Pressure; Dehydroepiandrosterone; Desoxycorticosterone; Dexamethasone; Female; Humans; Hydrocortisone; Hypertension; Male; Metyrapone; Mineralocorticoids; Renin

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Gynecomastia; Humans; Hypertension; Libido; Male; Middle Aged

Topics: 17-Ketosteroids; Adult; Aged; Female; Humans; Hypertension; Middle Aged; Pregnanediol; Pregnanetriol

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Hyperplasia, Congenital; Adrenal Insufficiency; Humans; Hypertension; Male; Middle Aged; Steroid Hydroxylases

In order to analyse and quantitate the urinary 16-oxysteroids known or thought to be associated with hypertension, we have established for six 16-oxy-C19 reference steroids the following parameters: elution volume on lipophilic gel columns, gas chromatographic retention data expressed as methylene unit values of trimethylsilyl ether and O-methoxime trimethylsilyl ether derivatives on OV-1 and OV-17 packed columns and on SE-30 capillary column, and mass spectra of these compounds. These reference steroids were: 3 alpha, 16 alpha-dihydroxy-5 alpha-androstan-17-one, 3 alpha, 16 alpha-dihydroxy-5 beta-androstan-17-one, 3 beta, 16 alpha-dihydroxy-5 alpha-androstan-17-one, 3 beta, 16 alpha-dihydroxy-5-androsten-17-one, 3 beta, 16 beta-dihydroxy-5-androsten-17-one, 3 beta, 17 beta-dihydroxy-5-androsten-16-one and 3 alpha, 15 alpha-dihydroxy-5 beta-androstan-17-one. The proposed method was shown to be applicable to the specific analysis of 16-oxy-C19-steroids in biological samples since it achieved the selective isolation of these compounds from other steroids and their quantitative elution in a single fraction. The analysis of the urinary steroids of two patients with arterial hypertension demonstrated an elevated rate of 3 beta, 16 alpha-dihydroxy-5-androsten-17-one.

Topics: 17-Ketosteroids; Gas Chromatography-Mass Spectrometry; Humans; Hypertension

The Tohoku University method of fasting therapy was performed on 380 patients. The clinical results revealed an efficacy rate of 87%. With regard to psychosomatic diseases, irritable colon syndrome, neurocirculatory asthenia, mild diabetes mellitus, obesity and borderline hypertension were good indications for this therapy. In order to clarify the therapeutic mechanism, several clinical examinations were administered before, during and after therapy. EEG data was analysed according to the power spectral method. The peak frequency decreased as fasting progressed, while it increased as re-fed continued. Percent energy of alpha waves after fasting therapy was significantly higher than that of the pre-fasting stage. The dexamethasone suppression rate of urine 17-OHCS after fasting therapy was significantly lower than that of the pre-fasting stage. It seems that ketone nutrition may work as a strong stressor in the brain cell, temporarily placing all biological mechanisms in a stress state and then activating the natural healing power inherent to the human body, thereby bringing about homeostasis.

Topics: 11-Hydroxycorticosteroids; 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adult; Asthma; Child; Colonic Diseases, Functional; Dexamethasone; Diabetes Mellitus; Electroencephalography; Fasting; Female; Headache; Humans; Hypertension; Hyperventilation; Male; Middle Aged; Obesity; Psychophysiologic Disorders

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex; Androgens; Child; Circadian Rhythm; Female; Humans; Hypertension; Male

Plasma 11-deoxycorticosterone levels were manyfold elevated in three adult patients with hypertension and elevated urinary excretion levels of 17-ketosteroids but without Cushing's syndrome. Dexamethasone therapy resulted in suppression of these steroids and in improvement of blood pressure in two of the patients. A partial adrenal 11beta-hydroxylase deficiency appears to best explain these findings.

Topics: 17-Ketosteroids; Adrenal Glands; Adult; Age Factors; Blood Pressure; Cushing Syndrome; Desoxycorticosterone; Dexamethasone; Female; Humans; Hypertension; Male; Mixed Function Oxygenases

Topics: 17-Ketosteroids; Acebutolol; Chromatography, Gas; Colorimetry; Humans; Hypertension

The effect of indomethacin on plasma renin activity (PRA), urinary aldosterone, 17 OH ketogenic steroids and plasma cortisol was studied in twenty-three patients with essential hypertension and compared in eleven patients to oxprenolol effect by 2 x 2 factorial trial. Indomethacin decreased PRA and urinary aldosterone: its effect was maintained when the drug was given for three days and it was related to basal PRA and aldosterone values. Therefore in patients with low PRA (renin-sodium index) PRA and aldosterone were unchanged, while they decreased in the normal high PRA group. Aldosterone changes were related to those of PRA, while 17 OH ketogenic steroids and plasma cortisol were unchanged. Both indomethacin and oxprenolol decreased PRA, but no interaction or additive effect was found between the two drugs. The present data indicate that indomethacin can decrease both PRA and aldosterone to an extent which is related to basal values and that aldosterone changes are mainly explained by those of PRA. The PRA unresponsiveness to indomethacin found in low renin patients may suggest renal prostaglandin deficiency. Finally the lack of interaction or of additive effect between indomethacin and oxprenolol may be explained by postulating either that the two drugs act on a common pathway or that an additive effect on PRA cannot be detected renin being maximally suppressed by full renal beta-receptors blockade.

Topics: 17-Ketosteroids; Adult; Aldosterone; Drug Therapy, Combination; Female; Humans; Hydrocortisone; Hypertension; Indomethacin; Male; Oxprenolol; Renin

A 17 year old female patient with hypertension, amenorrhoea and hirsutism was found to have subnormal levels of plasma and urinary cortisol, significant plasma levels of Reichstein's compound S and 21-deoxycortisol, high urinary levels of THS and pregnanetriolone as well as elevated levels of plasma and urinary testosterone. Treatment with 0.5 mg/day of dexamethasone or 25 mg/day cortisone reduced her hypertension and restored her menstrual cycles, but also resulted in the development of moon face, body striae and a gain in weight. Lower doses of cortisone were without effect. The deficient cortisol production coupled with the presence of unusual intermediates such as Reichstein's compound S and 21-deoxycortisol can be explained by a shift in the substrate specificity of 11beta-hydroxylase from C-21-hydroxylated substrates (i.e. compound S) to C-21-deoxy substrates (i.e. 17-hydroxyprogesterone).

Topics: 17-Ketosteroids; Adolescent; Adrenal Hyperplasia, Congenital; Amenorrhea; Corticosterone; Female; Hirsutism; Humans; Hydrocortisone; Hydroxyprogesterones; Hypertension; Pregnanetriol; Pregnenediones; Steroid Hydroxylases; Syndrome; Testosterone; Thyrotropin; Transcortin

The case of a young boy who had Cushing's syndrome and severe hypertension in association with metastatic adrenal carcinoma is described. Marked elevation of the mineralocorticoid 11-deoxycorticosterone was demonstrated in the plasma. 11-Deoxycortisol, 17alpha-hydroxyprogesterone, and urinary tetrahydro-11-deoxycortisol and pregnanetriol were also elevated. Aldosterone excretion was low. The data implicate defective 11beta hydroxylation and suggest that excessive 11-deoxycorticosterone production may have been responsible for the hypertension.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Aldosterone; Carcinoma; Child; Cortodoxone; Desoxycorticosterone; Humans; Hydrocortisone; Hydroxyprogesterones; Hypertension; Male; Pregnanetriol

A unique syndrome in a three-year-old American Indian girl was characterized by signs and symptoms of mineralocorticoid excess in the absence of excessive secretion of any known sodium-retaining steroids. Hypertension and hypokalemic alkalosis were corrected by spironolactone or a low sodium diet. Plasma renin activity was suppressed but the secretion of aldosterone was undetectable and was not stimulated by salt depletion. There was no evidence of abnormal accumulation of aldosterone precursors and metabolism of a tracer dose of the hormone was normal. Secretion rates of cortisol, corticosterone, deoxycorticosterone, deoxycortisol and aldosterone were very low and did not increase normally with ACTH administration. However ACTH administration aggravated hypertension and hypokalemia. Dexamethasone did not improve hypertension. Despite low secretion of glucocorticoids and mineralocorticoids, the patient showed no addisonian features and survived severe illness. Secretion of a factor of adrenocortical origin was suggested by the exacerbation of the syndrome of ACTH. The unidentified factor appears to be both a potent glucocorticoid and mineralocorticoid.

Topics: 17-Ketosteroids; Aldosterone; Blood Pressure; Body Weight; Child, Preschool; Chlorothiazide; Dexamethasone; Female; Humans; Hydrocortisone; Hydroxysteroids; Hypertension; Mineralocorticoids; Potassium; Renin; Sodium; Steroids

A moderate elevation of the daily excretion of free noradrenaline and adrenalin is observed in chronic circulatory insufficiency, beginning with Stage IIA. The catecholamines metabolism is elevated, as shown by the daily excretion of normethanpherine and methanpherine and of vanillyl-mandelic acid. The activity of renin and angiotensinases was growing along with the progressing cardiac insufficiency. The blood level of angiotensinogen was decreasing, especially in patients with Stage IIB and III of decompensation. The daily excretion of aldosterone was growing along with the development of cardiac insufficiency. The functional state of the glucocorticoid function of the adrenal cortex was of a phased nature in cases of circulatory insufficiency. The study of the functional state of the epiphysis was conducted by way of determining the blood level of melatonine and of its daily excretion. In Stages I and IIA the level of this hormone was clearly elevated, in Stages IIB and III -- decreased as compared with the initial and normal levels. The plasma level of the antidiuretic hormone was distinctly growing, beginning with Stage IIB, reaching its maximal values in Stage III.

Topics: 17-Ketosteroids; Adult; Aged; Aldosterone; Angiotensinogen; Coronary Disease; Cortisone; Endopeptidases; Epinephrine; Female; Heart Failure; Humans; Hydrocortisone; Hypertension; Male; Melatonin; Metanephrine; Middle Aged; Norepinephrine; Normetanephrine; Renin; Tetrahydrocortisol; Tetrahydrocortisone; Vanilmandelic Acid

1. Using a newly developed and validated radioassay method, we have measured plasma 11-deoxycorticosterone concentrations in a wide spectrum of human hypertensive states. 2. Patients with essential and renovascular hypertension have normal plasma concentrations of 11-deoxycorticosterone. 3. Elevated concentrations are seen in some patients with primary aldosteronism, Cushing's syndrome, low-renin hypertension, and in adult hypertensive subjects with elevated urinary 17-ketosteroid excretion. 4. An aetiological role for deoxycorticosterone in certain forms of human hypertension appears likely.

Topics: 17-Ketosteroids; Cushing Syndrome; Desoxycorticosterone; Humans; Hyperaldosteronism; Hypertension

Topics: 17-Ketosteroids; Adult; Aged; Carbon Radioisotopes; Chromatography; Chromatography, Gas; Chromatography, Ion Exchange; Chromatography, Thin Layer; Female; Glucuronidase; Humans; Hypertension; Methods; Middle Aged; Oxidation-Reduction; Silicon Dioxide; Sulfatases; Tritium

Steroid production, plasma renin activity (PRA) and plasma renin substrate (PRS) were measured in eight patients with hypertension due to Cushing's syndrome of benign origin. Despite elevation of cortisol secretion in all patients, hypokalemia and suppressed PRA was noted in the one subject with a functioning adrenal adenoma. PRA was normal in six patients on an unrestricted sodium intake but was markedly increased in the two patients on low salt diets. PRS was significantly increased during active disease, but decreased substantially with treatment. The absence of uniform hypokalemia and of suppression of renin indicates that mineralocorticoid production could not account for the increase in arterial pressure. It is suggested that glucocorticoid-induced hypertension may be initiated by alterations in vascular responsiveness to pressor agents and that elevated PRS levels may contribute to increase angiotensin formation.

Topics: 17-Ketosteroids; Adult; Angiotensin II; Cushing Syndrome; Diet; Female; Humans; Hydrocortisone; Hydroxysteroids; Hypertension; Male; Middle Aged; Potassium; Renin; Sodium Chloride

Topics: 17-Ketosteroids; Adrenal Glands; Adult; Aged; Aldosterone; Epinephrine; Female; Heart Failure; Hemodynamics; Humans; Hydrocortisone; Hypertension; Kallikreins; Kinins; Male; Middle Aged; Myocardial Infarction; Neurotransmitter Agents; Norepinephrine; Renin; Shock, Cardiogenic; Sympathetic Nervous System

Topics: 17-Ketosteroids; Adult; Dehydroepiandrosterone; Female; Humans; Hypertension; Male; Middle Aged; Neoplasms

Topics: 17-Ketosteroids; Adrenal Glands; Animals; Blood Pressure; Body Weight; Cholesterol; Corticosterone; Fatty Acids, Nonesterified; Heart; Hypertension; Kidney; Male; Organ Size; Rats; Rodent Diseases; Spleen; Thymus Gland

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adult; Aged; Aldosterone; Child; Child, Preschool; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Hypertension; Hypertension, Malignant; Hypertension, Renal; Male; Middle Aged; Pheochromocytoma; Potassium; Renin; Sodium; Sweat

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Glands; Adult; Aldosterone; Catecholamines; Female; Glucocorticoids; Humans; Hypertension; Male; Middle Aged; Renin

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Aged; Alpha-Globulins; Anabolic Agents; Arteriosclerosis; Beta-Globulins; Cerebrovascular Disorders; Female; gamma-Globulins; Humans; Hypertension; Male; Middle Aged

Topics: 17-Ketosteroids; Adult; Aged; Aldosterone; Chromatography, Gas; Desoxycorticosterone; Dexamethasone; Female; Humans; Hydroxycorticosteroids; Hypertension; Hypokalemia; Male; Middle Aged; Potassium; Radioimmunoassay; Renin; Spironolactone; Syndrome

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Glands; Aged; Arteriosclerosis; Cerebrovascular Disorders; Dehydroepiandrosterone; Erythrocytes; Female; Humans; Hypertension; Male; Middle Aged; Potassium; Sodium

Topics: 17-Ketosteroids; Acne Vulgaris; Adrenal Glands; Adult; Blood Cell Count; Cushing Syndrome; Diabetes Complications; Diagnosis, Differential; Ecchymosis; Female; Hirsutism; Humans; Hydrocortisone; Hypertension; Ketosteroids; Male; Obesity

Topics: 17-Ketosteroids; Adult; Age Factors; Aged; Aldosterone; Androstenes; Androsterone; Blood Pressure; Carbon Isotopes; Chromatography, Gas; Creatinine; Dehydroepiandrosterone; Etiocholanolone; Female; Glucuronates; Humans; Hypertension; Male; Middle Aged; Oxidoreductases; Sex Factors; Steroid Hydroxylases; Sulfuric Acids; Tritium

Topics: 17-Ketosteroids; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Aged; Androstanes; Breast Neoplasms; Castration; Dehydroepiandrosterone; Dexamethasone; Estradiol; Estrone; Female; Humans; Hydrocortisone; Hypertension; Iliac Vein; Male; Menopause; Middle Aged; Neoplasms; Radioligand Assay; Renal Veins; Testis; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Age Factors; Aldosterone; Diet Therapy; Humans; Hyperaldosteronism; Hypertension; Potassium; Sodium; Spironolactone; Time Factors

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Aldosterone; Corticosterone; Desoxycorticosterone; Dexamethasone; Disorders of Sex Development; Estrogens; Humans; Hydroxycorticosteroids; Hypertension; Hypokalemia; Karyotyping; Male; Metabolic Diseases; Mixed Function Oxygenases; Pregnanediol; Pregnenolone; Progesterone

Topics: 17-Ketosteroids; Adrenal Glands; Aged; Androgens; Antihypertensive Agents; Female; Humans; Hypertension; Male; Middle Aged; Phytotherapy; Plants, Medicinal; Rauwolfia

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Diseases; Adrenal Glands; Age Factors; Aged; Diabetes Mellitus; Humans; Hypertension; Male

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adult; Aged; Androstanes; Circadian Rhythm; Female; Humans; Hydroxysteroids; Hyperaldosteronism; Hypertension; Ketosteroids; Male; Middle Aged; Mineralocorticoid Receptor Antagonists; Pregnanes; Propionates; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Humans; Hyperaldosteronism; Hypertension; Potassium

Topics: 17-Ketosteroids; Adrenal Glands; Anabolic Agents; Animals; Arteries; Arteriosclerosis; Aspartate Aminotransferases; Blood Glucose; Blood Urea Nitrogen; Body Weight; Cholesterol; Corticosterone; Fatty Acids, Nonesterified; Female; Heart; Hypertension; Islets of Langerhans; Kidney; Male; Organ Size; Ovary; Pancreas; Rats; Renal Artery; Testis; Thymus Gland; Triglycerides

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Glands; Adult; Humans; Hypertension; Ischemia; Kidney; Middle Aged; Potassium; Sodium

Topics: 17-Ketosteroids; Adrenal Glands; Aldosterone; Germany, East; Humans; Hyperaldosteronism; Hypertension; Hypertension, Renal; Kidney; Mandelic Acids; Renin

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adult; Carbohydrate Metabolism; Cushing Syndrome; Female; Glucocorticoids; Humans; Hypertension; Male; Middle Aged; Osteoporosis

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Adrenocorticotropic Hormone; Child; Child, Preschool; Corticosterone; Desoxycorticosterone; Dexamethasone; Diet; Female; Humans; Hydrocortisone; Hyperplasia; Hypertension; Male; Metabolism, Inborn Errors; Metyrapone; Mixed Function Oxygenases; Potassium; Pregnanetriol; Secretory Rate; Sodium

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Androgens; Glucocorticoids; Humans; Hypertension; Methods; Middle Aged; Time Factors

Topics: 17-Ketosteroids; Adolescent; Adult; Aged; Depression; Epilepsy; Female; Gastrointestinal Diseases; Heart Diseases; Humans; Hypersensitivity; Hypertension; Kidney Diseases; Liver Diseases; Male; Middle Aged; Polyneuropathies; Respiratory Tract Diseases; Rheumatic Diseases

Topics: 17-Ketosteroids; Adult; Age Factors; Angiography; Blood Flow Velocity; Blood Pressure; Creatinine; Diet, Sodium-Restricted; Hemodynamics; Homeostasis; Humans; Hypertension; Kidney; Kidney Function Tests; Mandelic Acids; Natriuresis; Perfusion; Sodium; Water-Electrolyte Balance

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adult; Aged; Aldosterone; Angiotensin II; Animals; Biological Assay; Diagnosis, Differential; Female; Furosemide; Humans; Hyperaldosteronism; Hypertension; Hypokalemia; Male; Middle Aged; Posture; Potassium; Rats; Renin; Saliva; Sodium; Water-Electrolyte Balance

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Aldosterone; Angiotensin II; Chlorides; Creatinine; Desoxycorticosterone; Diet; Humans; Hypertension; Male; Middle Aged; Potassium; Renin; Secretory Rate; Sodium

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Adrenal Rest Tumor; Adrenocorticotropic Hormone; Aldosterone; Chemistry, Clinical; Child; Desoxycorticosterone; Etiocholanolone; Female; Humans; Hyperaldosteronism; Hyperplasia; Hypertension; Metabolism, Inborn Errors; Mixed Function Oxygenases; Ovarian Neoplasms; Pregnanetriol

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Child; Cortisone; Dichlorodiphenyldichloroethane; Estrogens; Female; Gonadotropins; Humans; Hypertension; Pregnanediol; Pregnanetriol; Prognosis; Puberty; Puberty, Precocious; Virilism

Topics: 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Azathioprine; Child; Epiphyses, Slipped; Female; Glomerulonephritis; Growth Disorders; Growth Substances; Histocompatibility Testing; Humans; Hypertension; Hypoglycemia; Immunosuppression Therapy; Insulin; Kidney; Kidney Transplantation; Male; Prednisone; Proteinuria; Social Adjustment; Transplantation Immunology; Transplantation, Homologous

Topics: 17-Ketosteroids; Catecholamines; Female; Humans; Hypertension; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Aldosterone; Blood Pressure; Catecholamines; Chlorothiazide; Creatinine; Diagnosis, Differential; Diet; Epinephrine; Humans; Hyperaldosteronism; Hypertension; Hypertension, Renal; Hypokalemia; Infusions, Parenteral; Norepinephrine; Potassium; Renal Artery Obstruction; Renin; Sodium; Vanilmandelic Acid

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Glands; Adult; Angiography; Carcinoma; Child; Cushing Syndrome; Female; Humans; Hypertension; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Pheochromocytoma; Renal Artery; Surgical Procedures, Operative; Thymoma; Urography; Vena Cava, Inferior

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adult; Alkalosis; Electrolytes; Female; Humans; Hyperaldosteronism; Hypertension; Hypokalemia; Renin; Spironolactone

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Hyperplasia, Congenital; Female; Humans; Hypertension; Male; Mixed Function Oxygenases; Oxidoreductases; Sodium Chloride

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenalectomy; Adult; Aldosterone; Androgens; Child; Desoxycorticosterone; Dexamethasone; Diet; Estrogens; Female; Follow-Up Studies; Glucocorticoids; Humans; Hydrocortisone; Hyperaldosteronism; Hypertension; Male; Middle Aged; Potassium; Prednisone; Renin; Secretory Rate; Sodium; Spironolactone

Topics: 17-Ketosteroids; Adolescent; Adrenal Glands; Adult; Aged; Androgens; Basal Metabolism; Female; Humans; Hypertension; Iodine Radioisotopes; Male; Middle Aged; Thyroid Gland

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Chemistry, Clinical; Humans; Hypertension; Methods; Periodic Acid; Pregnanes

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Aldosterone; Carbon Dioxide; Child; Child, Preschool; Chlorine; Desoxycorticosterone; Female; Humans; Hypertension; Infant, Newborn; Male; Natriuresis; Potassium; Prednisolone; Renin; Sodium; Sodium Chloride; Virilism

Topics: 17-Ketosteroids; Adrenal Gland Diseases; Child, Preschool; Chromatography; Clitoris; Female; Humans; Hyperplasia; Hypertension; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Methyldopa; Steroids; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Chromatography; Humans; Hypertension; Male; Methods; Metyrapone; Obesity

Topics: 17-Ketosteroids; Adrenal Glands; Female; Humans; Hypertension; Iodine; Iodine Radioisotopes; Male; Pituitary-Adrenal Function Tests; Thyroid Function Tests; Thyroid Gland

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Blood Pressure; Body Temperature; Burns; Catecholamines; Child; Child, Preschool; Female; Hematocrit; Humans; Hypertension; Infant; Male

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenalectomy; Humans; Hyperaldosteronism; Hypertension; Male; Middle Aged; Renin

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenalectomy; Adrenocortical Hyperfunction; Adult; Carcinoma; Child; Child, Preschool; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Hypertension; Intestinal Polyps; Male; Pheochromocytoma

Topics: 17-Ketosteroids; Adrenal Glands; Adrenocortical Hyperfunction; Cerebrovascular Disorders; Glucocorticoids; Humans; Hypertension; Methods; Pituitary-Adrenal Function Tests; Potassium; Sodium

Topics: 17-Ketosteroids; Adult; Basal Metabolism; Blood Proteins; Brain Diseases; Cervical Vertebrae; Dehydroepiandrosterone; Diencephalon; Female; Glaucoma; Humans; Hypertension; Hypothalamus; Intraocular Pressure; Male; Memory; Middle Aged; Migraine Disorders; Muscles; Osteochondritis; Pituitary-Adrenal System

A father and son are described with a condition characterized by benign hypertension, potassium deficiency, increased aldosterone secretion rate (ASR), raised plasma volume and suppressed plasma renin activity (PRA). There were intermittent elevations of urine 17-ketosteroids and 17-hydroxycorticoids (17-OHCS) but no increase in urine THS, normal circadian rhythm of plasma 17-OHCS, and normal urine 17-OHCS response to dexamethasone and intravenous ACTH. Plasma ACTH and corticosterone secretion were not elevated. Pregnanetriol excretion was normal but urine pregnanediol was increased. At operation on the father no adrenal tumour was found; the excised left adrenal weighed 7 g. and showed nodular cortical hyperplasia; juxtaglomerular cells showed only occasional granules. Following operation hypertension persisted and ASR was half the preoperative value. All abnormalities in father and son were relieved by dexamethasone (DM) 2 mg. daily. The condition recurred following cessation of DM but was relieved by a second course of treatment. No such response to DM was seen in a normal subject or in a patient with Conn's syndrome. For a number of reasons it is suggested that patients with hypertension, increased ASR and low PRA be given a trial of dexamethasone treatment before undergoing adrenal surgery.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Adult; Dexamethasone; Diagnosis, Differential; Female; Humans; Hyperaldosteronism; Hypertension; Male; Middle Aged; Potassium Deficiency; Renin

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Hyperplasia, Congenital; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Aged; Child; Child, Preschool; Endocrine System Diseases; Female; Humans; Hypertension; Liver Cirrhosis; Male; Metyrapone; Middle Aged; Paramethasone; Pregnanetriol; Triparanol

Topics: 17-Ketosteroids; Acute Disease; Adrenal Glands; Cerebral Hemorrhage; Cerebrovascular Disorders; Encephalomalacia; Eosinophils; Humans; Hypertension; Intracranial Arteriosclerosis; Intracranial Embolism and Thrombosis; Rheumatic Diseases; Syphilis, Cardiovascular

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Glands; Animals; Blood; Blood Pressure; Chromatography; Dexamethasone; Dogs; Enzymes; Female; Hyperplasia; Hypertension; Hypokalemia; In Vitro Techniques; Male; Metyrapone; Mixed Function Oxygenases; Organ Size; Polyuria; Potassium; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Cushing Syndrome; Diabetes Mellitus; Female; Humans; Hyperplasia; Hypertension; Infant; Infant, Newborn; Male; Obesity; Osteoporosis

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acne Vulgaris; Adolescent; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Adult; Amenorrhea; Brain; Diagnosis; Female; Hirsutism; Humans; Hypertension; Metabolic Diseases; Mixed Function Oxygenases; Obesity; Urine; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Aged; Blood; Chlorides; Edema; Female; Heart Diseases; Humans; Hypertension; Male; Middle Aged; Polythiazide; Potassium; Sodium; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocorticotropic Hormone; Cortisone; Cushing Syndrome; Dexamethasone; Female; Fludrocortisone; Humans; Hydrocortisone; Hypertension; Physiology; Pituitary-Adrenal Function Tests; Urine; Virilism

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenogenital Syndrome; Anxiety; Cushing Syndrome; Diagnosis, Differential; Hypertension; Liver Neoplasms; Neoplasm Metastasis; Nephrectomy; Pathology; Urine; Urography

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenocortical Adenoma; Child; Humans; Hyperaldosteronism; Hypernatremia; Hypertension; Hypertrichosis; Hypokalemia; Potassium; Sodium; Spironolactone; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Biomedical Research; Electric Stimulation; Hypertension; Kidney; Steroids; Urine

Topics: 17-Ketosteroids; Adolescent; Cushing Syndrome; Humans; Hypertension; Obesity; Puberty; Sexual Maturation

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acne Vulgaris; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenocortical Carcinoma; Adrenocorticotropic Hormone; Androgens; Androsterone; Antineoplastic Agents; Diuretics; Edema; Estrogens; Etiocholanolone; Feminization; Humans; Hydroxylation; Hypertension; Male; Metyrapone; Neoplasms; Pharmacology

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenocorticotropic Hormone; Hypertension; Pituitary-Adrenal Function Tests

Topics: 17-Ketosteroids; 46, XX Disorders of Sex Development; Disorders of Sex Development; Female; Genitalia, Female; Humans; Hypertension; Male; Urethra; Urine

Topics: 17-Ketosteroids; Adrenal Cortex; Androgens; Hypertension; Pituitary-Adrenal Function Tests; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Blood Chemical Analysis; Glucocorticoids; Hypertension; Urine

Topics: 17-Ketosteroids; Adrenal Cortex; Humans; Hypertension

Topics: 17-Ketosteroids; Amniotic Fluid; Edema; Female; Humans; Hypertension; Labor, Obstetric; Nephrotic Syndrome; Polyhydramnios; Pregnancy; Pregnancy Complications

Topics: 17-Ketosteroids; Essential Hypertension; Humans; Hypertension; Steroids

Topics: 17-Ketosteroids; Diet; Diet, Sodium-Restricted; Essential Hypertension; Humans; Hydroxysteroids; Hypertension; Sodium Chloride; Sodium Chloride, Dietary; Steroids; Urine

Topics: 17-Ketosteroids; Androgens; Animals; Blood Pressure; Hypertension; Rabbits; Urine

Topics: 17-Ketosteroids; Androgens; Animals; Blood Pressure; Hypertension; Rabbits

Topics: 17-Ketosteroids; Blood Pressure; Blood Pressure Determination; Humans; Hypertension; Protein Deficiency; Sodium Chloride