Abstract
Abstract The blood pressures of patients with spironolactone-responsive low-renin essential hypertension were favorably affected by double blind treatment with amino-glutethimide (an inhibitor of conversion of cholesterol to all types of hormonal steroids) and by WIN 24,540 (an inhibitor of the conversion of 5-ene to 4-ene steroids) but were not favorably affected by dexamethasone (an inhibitor of ACTH-dependent steroidogenesis) or metyrapone (an inhibitor of 11-hydroxylation). Patients with primary aldosterone responded similarly except that their blood pressures also responded favorably to metyrapone. Patients with essential hypertension and normal plasma renin activity failed to respond to any of these treatments. It is concluded that in patients with low-renin essential hypertension a mineralocorticoid plays a major role in the maintenance of the hypertension. In the majority of patients a non-ACTH dependent 4-ene steroid appears to be involved. Aldosterone does not appear to play a major pathogenetic role in maintaining the hypertension of patients with the syndrome of low-renin essential hypertension.
Published Version
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