Effect of aminoglutethimide on blood pressure and steroid secretion in patients with low renin essential hypertension

A. A. Taylor, J. R. Mitchell, F. C. Bartter, W. R. Snodgrass, R. J. McMurtry, J. R. Gill, R. B. Franklin

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

An inhibitor of adrenal steroid biosynthesis, aminoglutethimide, was administered to seven patients with low renin essential hypertension, and the antihypertensive action of the drug was compared with its effects on adrenal steroid production. In all patients aldosterone concentrations in plasma and urine were within normal limits before the study. Mean arterial pressure was reduced from a pretreatment value of 117±2 (mean±SE) mm Hg to 108±3 mm Hg after 4 days of aminoglutethimide therapy and further to 99±3 mm Hg when drug administration was stopped (usually 21 days). Body weight was also reduced from 81.6±7.2 kg in the control period to 80.6±7.0 kg after 4 days of drug treatment and to 80.1±6.7 kg at the termination of therapy. Plasma renin activity was not significantly increased after 4 days of treatment but had risen to the normal range by the termination of aminoglutethimide therapy. Mean plasma concentrations of deoxycorticosterone and cortisol were unchanged during aminoglutethimide treatment whereas those of 18-hydroxydeoxycorticosterone, progesterone, 17α-hydroxyprogesterone, and 11-deoxycortisol were increased as compared to pretreatment values. In contrast, aminoglutethimide treatment reduced mean plasma aldosterone concentrations to about 30% of control values. Excretion rates of 16β-hydroxydehydroepiandrosterone, 16-oxo-androstenediol, 17-hydroxycorticosteroids and 17-ketosteroids, and the secretion rate of 16β-hydroxydehydroepiandrosterone were not significantly altered by aminoglutethimide treatment whereas the excretion rate of aldosterone was reduced from 3.62±0.5 (mean±SE) in the control period to 0.9±0.2 μg/24 h after 4 days and to 1.1±0.3 μg/24 h at the termination of aminoglutethimide treatment. The gradual lowering of blood pressure and body weight during aminoglutethimide therapy is consistent with the view that the antihypertensive effect of the drug is mediated through a reduction in the patients' extracellular fluid volume, probably secondary to the persistent decrease in aldosterone production. The observation that chronic administration of aminoglutethimide lowered blood pressure in these patients and elevated their plasma renin activity to the normal range without decreasing production of the adrenal steroids, deoxycorticosterone, 18-hydroxydeoxycorticosterone, and 16β-hydroxydehydroepiandrosterone, makes it unlikely that these steroids are responsible either for the decreased renin or the elevated blood pressure in patients with low renin essential hypertension.

Original languageEnglish (US)
Pages (from-to)162-168
Number of pages7
JournalJournal of Clinical Investigation
Volume62
Issue number1
StatePublished - 1978
Externally publishedYes

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Aminoglutethimide
Renin
Steroids
Blood Pressure
Aldosterone
Therapeutics
Desoxycorticosterone
Antihypertensive Agents
Reference Values
Androstenediol
Body Weight
17-Hydroxycorticosteroids
Cortodoxone
Essential Hypertension
17-alpha-Hydroxyprogesterone
17-Ketosteroids
Extracellular Fluid
Pharmaceutical Preparations
Progesterone
Hydrocortisone

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Taylor, A. A., Mitchell, J. R., Bartter, F. C., Snodgrass, W. R., McMurtry, R. J., Gill, J. R., & Franklin, R. B. (1978). Effect of aminoglutethimide on blood pressure and steroid secretion in patients with low renin essential hypertension. Journal of Clinical Investigation, 62(1), 162-168.

Effect of aminoglutethimide on blood pressure and steroid secretion in patients with low renin essential hypertension. / Taylor, A. A.; Mitchell, J. R.; Bartter, F. C.; Snodgrass, W. R.; McMurtry, R. J.; Gill, J. R.; Franklin, R. B.

In: Journal of Clinical Investigation, Vol. 62, No. 1, 1978, p. 162-168.

Research output: Contribution to journalArticle

Taylor, AA, Mitchell, JR, Bartter, FC, Snodgrass, WR, McMurtry, RJ, Gill, JR & Franklin, RB 1978, 'Effect of aminoglutethimide on blood pressure and steroid secretion in patients with low renin essential hypertension', Journal of Clinical Investigation, vol. 62, no. 1, pp. 162-168.
Taylor AA, Mitchell JR, Bartter FC, Snodgrass WR, McMurtry RJ, Gill JR et al. Effect of aminoglutethimide on blood pressure and steroid secretion in patients with low renin essential hypertension. Journal of Clinical Investigation. 1978;62(1):162-168.
Taylor, A. A. ; Mitchell, J. R. ; Bartter, F. C. ; Snodgrass, W. R. ; McMurtry, R. J. ; Gill, J. R. ; Franklin, R. B. / Effect of aminoglutethimide on blood pressure and steroid secretion in patients with low renin essential hypertension. In: Journal of Clinical Investigation. 1978 ; Vol. 62, No. 1. pp. 162-168.
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