Abstract
The hypothesis that a steroid can produce hypertension in man was tested in an 18 yr. old male with dexamethasone-suppressible hypertension. Reinvestigation after 6 yrs. of little or no treatment demonstrated that the hypertension and mild hyperaldosteronism were promptly decreased by a small dose of dexamethasone. During dexamathasone treatment, when aldosterone secretion was suppressed to less than normal and he was normotensive, steroids were given by constant infusion in an attempt to reproduce the hypertension of the dexamethasone-free state. Neither 5 days of aldosterone (A) nor 18-hydroxy desoxycorticosterone (18-OH DOC) at 1 mg/day nor DOC at 30 mg/day caused hypertension. However, Na+ retention and K+ loss was observed during A and DOC infusion. Hypertension was produced within 5 days during infusion of ACTH or oral metyrapone. The hypertensive effect of the latter was eliminated by addition of aminogluthethimide treatment. These studies suggest that an ACTH dependent steroid other than A, 18-OH DOC, or DOC may be the cause of the hypertension in this patient.
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