Plasma and Extracellular Fluid Volumes in Hypertension

Abnormalities of extracellular fluid volume (ECF) occur frequently in hypertension and are often related to diastolic arterial pressure (DBP). Among untreated patients, plasma volume (PV) was found to be reduced in essential (EH) and renovascular (RVH) hypertension and pheochromocytoma and inversely...

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Published in:	Circulation research Vol. 32; no. 5 Suppl No I; pp. I-73 - I-83
Main Authors:	DUSTON, HARRIET P, TARAZI, ROBERT C, BRAVO, EMMANUEL L, DART, RICHARD A
Format:	Journal Article
Language:	English
Published:	United States American Heart Association, Inc 05-05-1973
Subjects:	Aldosterone - urine Blood Pressure Diuretics - therapeutic use Extracellular Space Humans Hyperaldosteronism - physiopathology Hypertension - drug therapy Hypertension - physiopathology Hypertension, Renal - drug therapy Hypertension, Renal - physiopathology Kidney Diseases - physiopathology Pheochromocytoma - physiopathology Plasma Volume Potassium - blood Renal Artery Obstruction - physiopathology Renin - blood Serum Albumin, Radio-Iodinated Sodium - blood Sodium Chloride - pharmacology Sodium Isotopes Vascular Resistance
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Summary:	Abnormalities of extracellular fluid volume (ECF) occur frequently in hypertension and are often related to diastolic arterial pressure (DBP). Among untreated patients, plasma volume (PV) was found to be reduced in essential (EH) and renovascular (RVH) hypertension and pheochromocytoma and inversely related to DBP. In primary aldosteronism (1°A) and nonazotemic renal parenchymal disease, PV was normal or expanded. While in the former PV did not correlate significantly with DBP, in the latter a direct correlation was found. Reasons for PV abnormalities are not apparent, but in essential hypertension the reduction may reflect altered capillary filtering force, because total ECF was found to be normal, while the ratio of PV to interstitial fluid volume was significantly reduced. Probably significant in this regard, also, was the observation that total peripheral resistance and PV were inversely related in EH, RVH, and 1°A.Drug treatments modified conditions so that DBP became a direct function of PV in patients with EH, RVH, and 1°A. Thus, in EH and RVH patients treated with adrenergic blocking drugs alone or in combination with diuretics, good DBP control depended on maintaining a reduced PV. Also, in EH and 1°A during short-term sodium deprivation or long-term thiazide and/or spironolactone treatment, DBP and PV were directly related.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0009-7330 1524-4571