Wendy L. Finn

Clinical and pathological diversity of primary aldosteronism, including a new familial variety.

1. Of 93 patients with primary aldosteronism seen during a 20 year period, 52 had an aldosterone‐producing adenoma (APA) removed (five more await surgery), 14 had bilateral adrenal hyperplasia (BAH), three had glucocorticoid‐suppressible hyperaldosteronism (GSH), one had adrenal carcinoma and 18 are yet to be categorized.

Effects of Volume Expansion and Contraction On Plasma-Levels of Atrial Natriuretic Peptide in Man

1. Effects of saline infusion and blood removal on atrial natriuretic peptide (ANP) in normal subjects were examined in order to better define the magnitude of acute central volume regulatory influences on ANP.

EFFECTS OF ALTITUDE ON ATRIAL NATRIURETIC PEPTIDE: THE BICENTENNIAL MOUNT EVEREST EXPEDITION

1. Overnight recumbent atrial natriuretic peptide levels were significantly elevated in all ten subjects of the Australian Bicentennial Mount Everest Expedition during the first week at 5400 m, during acclimatization.

Reduced Adrenal Secretory Mass After Unilateral Adrenalectomy for Aldosterone-Producing Adenoma May Explain Unexpected Incidence of Hypotension

In a prospective study of 37 patients who had unilateral adrenalectomy for an aldosterone-producing adenoma, five of 33 (15%) were symptomatically hypotensive after at least 1 year, and eight of 29 (28%) who were observed 3, 6, 12, 18 and 24 months after the operation showed 2-year blood pressures below the fifth percentile for age- and sex-matched controls. Postoperatively, plasma aldosterone was lower, and plasma renin activity higher than in controls, these differences being more marked in the hypotensive group. Pre-operatively elevated atrial natriuretic factor fell to levels lower than in controls. These serial changes in volume-regulatory hormones are consistent with chronic hypovolaemia, due to relative hypoaldosteronism. Plasma cortisol was lower 6 months after the operation and plasma adrenaline levels fell by half. A reduced adrenocortical (aldosterone and cortisol) and adrenomedullary (adrenaline) secretory mass may play a role in the hypotension observed after unilateral adrenalectomy.

Biochemical correction in the syndrome of hypertension and hyperkalaemia by severe dietary salt restriction suggests renin-aldosterone suppression critical in pathophysiology.

1. Plasma potassium and chloride concentrations were raised and plasma renin activity, aldosterone, bicarbonate and arterial pH were reduced in two brothers with the syndrome of hypertension and hyperkalaemia with normal glomerular filtration rate (Gordons syndrome), on unrestricted or moderately restricted sodium diets.

A renin-secreting tumour sensitive to changes in central blood volume (presumably via sympathetics) but not to circulating angiotensin II.

1. A 17 year old female presented with severe hypertension, hypokalaemia and elevated levels of plasma renin activity due to a renin‐secreting tumour.

Renal Extraction of Atrial-Natriuretic-Peptide in Unilateral Renal-Artery Stenosis

1. Elevated peripheral atrial natriuretic peptide (ANP) levels were observed in 12 patients with unilateral renal artery stenosis (U‐RAS).

SODIUM AND VOLUME DYSREGULATION AFTER APPARENTLY NORMAL PREGNANCY IS SUGGESTED BY ABNORMAL LEVELS OF ATRIAL NATRIURETIC PEPTIDE, RENIN AND ALDOSTERONE

1. Plasma atrial natriuretic peptide (ANP), renin activity, aldosterone, sodium, potassium and serum total protein and albumin during and after 14 normal pregnancies were compared with age‐matched controls.

UNEXPECTED INCIDENCE OF LOW BLOOD PRESSURE 2 YEARS AFTER UNILATERAL ADRENALECTOMY FOR PRIMARY ALDOSTERONISM

1. Serial observations of blood pressure after unilateral adrenalectomy for aldosterone‐producing adenoma revealed an incidence of hypotension (systolic BP < fifth percentile for age‐ and sex‐matched normal population) of 27% at 2 years, more than 5 times that predicted.

PROSTAGLANDINS AND SYSTOLIC BLOOD PRESSURE, BUT NOT ANGIOTENSIN II, INDEPENDENTLY AFFECT ATRIAL NATRIURETIC PEPTIDE LEVELS IN MAN

1. Two hours after a single dose of indomethacin (INDO), plasma renin activity (PRA) and atrial natriuretic peptide (ANP) levels decreased, which is consistent with an effect of lowering prostaglandins (PG).