Abstract
Plasma aldosterone, 18-OH-DOC and Cortisol concentrations in both adrenal veins were
determined simultaneously in 21 hypertensive patients with suppressed plasma renin.
In aldosterone producing adenoma group plasma aldosterone was 5.2 and 18-OH-DOC 3.6
times higher on the side of adenoma. In idiopathic hyperaldosteronism with bilateral
adrenal hyperplasia the concentration of aldosterone and 18-OH-DOC was symmetrically
high on both sides. In low-renin essential hypertension plasma 18-OH-DOC was high,
aldosterone, however, was low in both adrenal venous effluent. Plasma concentration
of cortisol in adrenal veins did not differ in these 3 groups. In Cushing's syndrome
cortisol was high especially in the vein from the adrenal bearing an adenoma, aldosterone
was low on both sides and 18-OH-DOC showed a wide scatter. Administration of synthetic
ACTH increased aldosterone and 18-OH-DOC in a patient with aldosterone producing adenoma
and in 2 patients with low-renin essential hypertension. Long-term treatment with
Spironolactone lowered the adrenal venous plasma aldosterone. These results suggest
that simultaneous determination of aldosterone, 18-OH-DOC and cortisol in adrenal
veins is helpful in the differentiation of low-renin hypertensions and in localization
of an adrenocortical adenoma. Changes of aldosterone and 18-OH-DOC in adrenal plasma
after ACTH and Spironolactone demonstrate the ACTH dependence of aldosterone and 18-OH-DOC
and the inhibiting effect of Spironolactone on aldosterone production. These changes
are due to the direct influence of adrenal steroidogenesis and not only to changes
in peripheral steroid metabolism.
Key words
Aldosterone - 18-Hydroxy-Deoxycorticosterone - Cortisol-Adrenal Vein Concentration
- Low-Renin Hypertensions - ACTH Stimulation - Spironolactone
1 In an abbreviated form presented at the Vth International Congress of Endocrinology,
July 18-24, 176, Hamburg
