losartan-potassium and Hypovolemia

The study examined the distinct and synergistic effects of hypoxia and bed rest on the erythropoietin (EPO) concentration and relative changes in plasma volume (PV). Eleven healthy male lowlanders underwent three 21-day confinement periods, in a counterbalanced order: (1) normoxic bed rest (NBR; PIO2: 133.1 ± 0.3 mmHg); (2) hypoxic bed rest (HBR; PIO2: 90.0 ± 0.4 mmHg, ambient simulated altitude of ~4000 m); and (3) hypoxic ambulation (HAMB; PIO2: 90.0 ± 0.4 mmHg). Blood samples were collected before, during (days 2, 5, 14, and 21) and 2 days after each confinement to determineEPOconcentration. Qualitative differences inPVchanges were also estimated by changes in hematocrit and hemoglobin concentration along with concomitant changes in plasma renin concentration.NBRcaused an initial reduction inEPOby ~39% (P = 0.04). By contrast,HBRenhancedEPO(P = 0.001), but the increase was less than that induced byHAMB(P < 0.01). All three confinements caused a significant reduction inPV(P < 0.05), with a substantially greater drop inHBRthan in the other conditions (P < 0.001). Thus, present results suggest that hypoxia prevents theEPOsuppression, whereas it seems to exaggerate thePVreduction induced by bed rest.

Topics: Activities of Daily Living; Adult; Bed Rest; Biomarkers; Blood Pressure; Down-Regulation; Erythropoietin; Exercise; Healthy Volunteers; Heart Rate; Humans; Hypovolemia; Hypoxia; Male; Motor Activity; Oxyhemoglobins; Plasma Volume; Renin; Time Factors; Young Adult

Patients with postural tachycardia syndrome (POTS) experience considerable disability, but in most, the pathophysiology remains obscure. Plasma volume disturbances have been implicated in some patients. We prospectively tested the hypothesis that patients with POTS are hypovolemic compared with healthy controls and explored the role of plasma renin activity and aldosterone in the regulation of plasma volume.. Patients with POTS (n=15) and healthy controls (n=14) underwent investigation. Heart rate (HR), blood pressure (BP), plasma renin activity, and aldosterone were measured with patients both supine and upright. Blood volumes were measured with 131I-labeled albumin and hematocrit. Patients with POTS had a higher orthostatic increase in HR than controls (51+/-18 versus 16+/-10 bpm, P<0.001). Patients with POTS had a greater deficit in plasma volume (334+/-187 versus 10+/-250 mL, P<0.001), red blood cell volume (356+/-128 versus 218+/-140 mL, P=0.010), and total blood volume (689+/-270 versus 228+/-353 mL, P<0.001) than controls. Despite the lower plasma volume in patients with POTS, there was not a compensatory increase in plasma renin activity (0.79+/-0.58 versus 0.79+/-0.74 ng x mL(-1) x h(-1), P=0.996). There was a paradoxically low level of aldosterone in the patients with POTS (190+/-140 pmol/L versus 380+/-230 pmol/L; P=0.017).. Patients with POTS have paradoxically unchanged plasma renin activity and low aldosterone given their marked reduction in plasma volume. These patients also have a significant red blood cell volume deficit, which is regulated by the renal hormone erythropoietin. These abnormalities suggest that the kidney may play a key role in the pathophysiology of POTS.

Topics: Adult; Aldosterone; Blood Volume; Case-Control Studies; Erythropoietin; Female; Hemodynamics; Humans; Hypovolemia; Male; Middle Aged; Posture; Prospective Studies; Renin; Renin-Angiotensin System; Tachycardia

Topics: Anemia; Erythropoietin; Humans; Hypovolemia; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care, Neonatal; Patient Care Planning; Platelet Transfusion; Risk Factors