Further Studies on Urinary Aldosterone in Human Arterial Hypertension.

Abstract

Thirty-three urinary aldosterone determinations were performed in normal subjects with the use of a new chemical method previously described (Can. J. of Biochem. and Physiol. 35, 425, 1957). The mean excretion was 3.6 ug/day with a range of 1 to 9.5 (mean 3.6 [plus or minus] 0.42). Fifty-four urinary aldosterone determinations were performed in 39 patients with essential, renal and malignant hypertension, without cardiac failure and maintained on unrestricted diets. The mean excretion in each of these 3 groups was twice the normal mean( p < 0.001). Fifty-five per cent had individual urinary aldosterone excretion higher than normal or in the higher normal range. Serial daily determinations of urinary aldosterone in several early hypertensive patients (of renal and essential origin) reveal a marked and significant fluctuation from normal to higher than normal levels whereas normal subjects have a fairly constant excretion well within normal limits. No reasons of stress, anxiety states, or of Na intake accounted for these fluctuations in early hypertension. No correlation could be observed between aldosterone excretion and the urinary Na/K or K/Na rations and the presence or absence of dyspnea on exertion. These findings bring additional evidence for an adrenocortical disturbance in human arterial hypertension.