cyclic-gmp and Hyperaldosteronism

Topics: Adrenal Gland Neoplasms; Calmodulin; Cushing Syndrome; Cyclic AMP; Cyclic GMP; Humans; Hyperaldosteronism; Hypertension; Leukocytes; Pheochromocytoma

The pharmacological effects of synthetic alpha-human atrial natriuretic peptide (alpha-hANP) in patients with Cushing's syndrome and primary aldosteronism were compared with those in normal volunteers. An infusion of synthetic alpha-hANP at 0.1 microgram/kg per min for 20 min produced a maximal plasma hANP level of 800-1200 pg/ml in patients with Cushing's syndrome and primary aldosteronism, and in normal subjects. There were significant decreases in the mean blood pressure (-10 to -15 mmHg) in patients with Cushing's syndrome and primary aldosteronism, similar to those in normal subjects. The plasma cyclic 3'5'-guanosine monophosphate (cGMP) concentrations of both groups of patients were increased fivefold over the baseline level following the infusion. Infusion of synthetic alpha-hANP caused a greater increase in the rate of sodium excretion in patients with Cushing's syndrome and primary aldosteronism compared with normal volunteers. The plasma cortisol and aldosterone concentrations did not, however, significantly change during alpha-hANP infusion in either the patients with Cushing's syndrome or those with primary aldosteronism. As synthetic alpha-hANP has a potent hypotensive effect in hypertensive patients with Cushing's syndrome and primary aldosteronism, a significant reduction in blood pressure and natriuresis seems to occur without affecting adrenocortical steroidogenesis.

Topics: Adult; Aldosterone; Atrial Natriuretic Factor; Blood Pressure; Cushing Syndrome; Cyclic GMP; Female; Humans; Hyperaldosteronism; Male; Middle Aged; Natriuresis; Peptide Fragments; Renin

To investigate the involvement of atrial natriuretic peptide (ANP) in secondary hypertension, we examined hormonal and renal responses to ANP infusion (0.025 microgram/kg/min) in 27 patients with renal parenchymal hypertension, 10 with primary aldosteronism, 8 with renovascular hypertension, and 15 normotensive subjects. The preinfusion plasma concentration of ANP was significantly higher in patients with renal parenchymal hypertension (120 pg/ml, p less than 0.01) and in patients with primary aldosteronism (98 pg/ml, p less than 0.05) than in the normotensive subjects (40 pg/ml), but it was not greater than in the patients with renovascular hypertension (73 pg/ml, NS). In the patients with renal parenchymal hypertension, plasma ANP correlated negatively with creatinine clearance (r = -0.76, p less than 0.001). Mean blood pressure (-5%, p less than 0.01) and plasma aldosterone (-40%, p less than 0.001) decreased to a similar degree in the four groups during ANP infusion. However, an increase in urinary sodium excretion caused by ANP was higher in the hypertensive than in the normotensive patients (+250% vs. +70%, p less than 0.01) and correlated positively with mean blood pressure during ANP infusion (r = 0.47, p less than 0.001). The removal of adenomas in the patients with primary aldosteronism significantly lowered both plasma levels of ANP and cyclic guanosine 2',3'-monophosphate and reduced an increase in sodium excretion during ANP infusion, whereas the responses of blood pressure and plasma aldosterone to ANP infusion were not altered by the operation. Thus, these results suggest that elevated ANP secretion and increased natriuretic responses to ANP may modify the blood pressure and body fluid volume status in some types of secondary hypertension.

Topics: Adrenal Gland Neoplasms; Aldosterone; Atrial Natriuretic Factor; Blood Pressure; Cyclic GMP; Hormones; Humans; Hyperaldosteronism; Hypertension, Renal; Hypertension, Renovascular; Kidney; Osmolar Concentration; Postoperative Period; Reference Values; Renin

Topics: Adrenal Gland Neoplasms; Adult; Chronic Disease; Cyclic AMP; Cyclic GMP; Female; Humans; Hyperaldosteronism; Hypertension; Hypertension, Renovascular; Kidney Diseases; Pheochromocytoma; Potassium; Pyelonephritis; Sodium

Primary cultures of dissociated parenchymal cells from Conn's adenomata causing primary hyperaldosteronism were successfully set up by a method previously used with normal adult human and rat adrenocortical tissue. In such cultures the adenomatous cells largely prevailed (making up 87% of the whole cell population), could survive for lengthy terms (at least up to 30 days), and were endowed with a spontaneous, discrete capability to proliferate. The de novo RNA- and DNA-synthetic and mitotic activities of Conn's cells were markedly stimulated in cultures exposed between 16 and 21 to daily doses of exogenous cyclic AMP, either alone or in equimolar association with cyclic GMP. A significantly weaker, though still prominent enhancement of adenomatous cell growth was elicited also by daily administrations of an equimolar mixture of ACTH1-24 and angiotensin II. In contrast, little stimulation or inhibition of growth or no effect at all could be observed when cyclic GMP, ACTH1-24, and angiotensin II were respectively administered, each by itself.

Topics: Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Angiotensin II; Cell Division; Cosyntropin; Culture Techniques; Cyclic AMP; Cyclic GMP; Humans; Hyperaldosteronism; Time Factors