The Relationship between Angiotensin and Aldosterone

Abstract

Publisher Summary Angiotensin plays an important part in the physiological control of aldosterone secretion. Although the precise role of the renin-angiotensin system in the physiological control of aldosterone secretion is yet to be defined, the investigation of this relationship has nonetheless yielded extremely useful information clinically. The angiotensin II can stimulate aldosterone secretion in man, and where circulating angiotensin II levels are high there is commonly a state of hyperaldosteronism. By contrast, when there is a primary increase in aldosterone secretion, the plasma renin activity and circulating plasma angiotensin II levels are often secondarily suppressed. The carcinoma of the adrenal cortex causes a clinical syndrome that is indistinguishable from the more common adenoma although steroid analysis usually distinguishes this group by demonstrating an increased cortisol production in those cases where aldosterone secretion is increased. The generally accepted proposition that the secondary aldosteronism associated with a variety of physiological and pathological states is because of increased activity of the renin–angiotensin system lacks critical proof.