Abnormal pressure natriuresis

A cause or a consequence of hypertension?

John E. Hall, H. Leland Mizelle, Drew A. Hildebrandt, Michael W Brands

Research output: Contribution to journalReview article

166 Citations (Scopus)

Abstract

In all forms of chronic hypertension, the renal-pressure natriuresis mechanism is abnormal because sodium excretion is the same as in normotension despite the increased blood pressure. However, the importance of this resetting of pressure natriuresis as a cause of hypertension is controversial. Theoretically, a resetting of pressure natriuresis could necessitate increased blood pressure to maintain sodium balance or it could occur secondarily to hypertension. Recent studies indicate that, in several models of experimental hypertension (including angiotensin II, aldosterone, adrenocorticotrophic hormone, and norepinephrine hypertension), a primary shift of renal-pressure natriuresis necessitates increased arterial pressure to maintain sodium and water balance. In genetic animal models of hypertension, there also appears to be a resetting of pressure natriuresis before the development of hypertension. Likewise, essential hypertensive patients exhibit abnormal pressure natriuresis, although the precise cause of this defect is not clear. It is likely that multiple renal defects contribute to resetting of pressure natriuresis in essential hypertensive patients. With long-standing hypertension, pathological changes that occur secondary to hypertension must also be considered. By analyzing the characteristics of pressure natriuresis in hypertensive patients and by comparing these curves to those observed in various forms of experimental hypertension of known origin, it is possible to gain insight into the etiology of this disease.

Original languageEnglish (US)
Pages (from-to)547-559
Number of pages13
JournalHypertension
Volume15
Issue number6 PART 1
StatePublished - Jun 1 1990
Externally publishedYes

Fingerprint

Natriuresis
Hypertension
Pressure
Sodium
Blood Pressure
Kidney
Renal Hypertension
Genetic Models
Aldosterone
Angiotensin II
Adrenocorticotropic Hormone
Norepinephrine
Arterial Pressure
Theoretical Models
Animal Models
Water

Keywords

  • Angiotensin
  • Atrial natriuretic factor
  • Blood pressure
  • Essential hypertension
  • Kidney
  • Renin
  • Sodium excretion

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Hall, J. E., Mizelle, H. L., Hildebrandt, D. A., & Brands, M. W. (1990). Abnormal pressure natriuresis: A cause or a consequence of hypertension? Hypertension, 15(6 PART 1), 547-559.

Abnormal pressure natriuresis : A cause or a consequence of hypertension? / Hall, John E.; Mizelle, H. Leland; Hildebrandt, Drew A.; Brands, Michael W.

In: Hypertension, Vol. 15, No. 6 PART 1, 01.06.1990, p. 547-559.

Research output: Contribution to journalReview article

Hall, JE, Mizelle, HL, Hildebrandt, DA & Brands, MW 1990, 'Abnormal pressure natriuresis: A cause or a consequence of hypertension?', Hypertension, vol. 15, no. 6 PART 1, pp. 547-559.
Hall JE, Mizelle HL, Hildebrandt DA, Brands MW. Abnormal pressure natriuresis: A cause or a consequence of hypertension? Hypertension. 1990 Jun 1;15(6 PART 1):547-559.
Hall, John E. ; Mizelle, H. Leland ; Hildebrandt, Drew A. ; Brands, Michael W. / Abnormal pressure natriuresis : A cause or a consequence of hypertension?. In: Hypertension. 1990 ; Vol. 15, No. 6 PART 1. pp. 547-559.
@article{354dee94d09b4ca49736f712cfa640bb,
title = "Abnormal pressure natriuresis: A cause or a consequence of hypertension?",
abstract = "In all forms of chronic hypertension, the renal-pressure natriuresis mechanism is abnormal because sodium excretion is the same as in normotension despite the increased blood pressure. However, the importance of this resetting of pressure natriuresis as a cause of hypertension is controversial. Theoretically, a resetting of pressure natriuresis could necessitate increased blood pressure to maintain sodium balance or it could occur secondarily to hypertension. Recent studies indicate that, in several models of experimental hypertension (including angiotensin II, aldosterone, adrenocorticotrophic hormone, and norepinephrine hypertension), a primary shift of renal-pressure natriuresis necessitates increased arterial pressure to maintain sodium and water balance. In genetic animal models of hypertension, there also appears to be a resetting of pressure natriuresis before the development of hypertension. Likewise, essential hypertensive patients exhibit abnormal pressure natriuresis, although the precise cause of this defect is not clear. It is likely that multiple renal defects contribute to resetting of pressure natriuresis in essential hypertensive patients. With long-standing hypertension, pathological changes that occur secondary to hypertension must also be considered. By analyzing the characteristics of pressure natriuresis in hypertensive patients and by comparing these curves to those observed in various forms of experimental hypertension of known origin, it is possible to gain insight into the etiology of this disease.",
keywords = "Angiotensin, Atrial natriuretic factor, Blood pressure, Essential hypertension, Kidney, Renin, Sodium excretion",
author = "Hall, {John E.} and Mizelle, {H. Leland} and Hildebrandt, {Drew A.} and Brands, {Michael W}",
year = "1990",
month = "6",
day = "1",
language = "English (US)",
volume = "15",
pages = "547--559",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams and Wilkins",
number = "6 PART 1",

}

TY - JOUR

T1 - Abnormal pressure natriuresis

T2 - A cause or a consequence of hypertension?

AU - Hall, John E.

AU - Mizelle, H. Leland

AU - Hildebrandt, Drew A.

AU - Brands, Michael W

PY - 1990/6/1

Y1 - 1990/6/1

N2 - In all forms of chronic hypertension, the renal-pressure natriuresis mechanism is abnormal because sodium excretion is the same as in normotension despite the increased blood pressure. However, the importance of this resetting of pressure natriuresis as a cause of hypertension is controversial. Theoretically, a resetting of pressure natriuresis could necessitate increased blood pressure to maintain sodium balance or it could occur secondarily to hypertension. Recent studies indicate that, in several models of experimental hypertension (including angiotensin II, aldosterone, adrenocorticotrophic hormone, and norepinephrine hypertension), a primary shift of renal-pressure natriuresis necessitates increased arterial pressure to maintain sodium and water balance. In genetic animal models of hypertension, there also appears to be a resetting of pressure natriuresis before the development of hypertension. Likewise, essential hypertensive patients exhibit abnormal pressure natriuresis, although the precise cause of this defect is not clear. It is likely that multiple renal defects contribute to resetting of pressure natriuresis in essential hypertensive patients. With long-standing hypertension, pathological changes that occur secondary to hypertension must also be considered. By analyzing the characteristics of pressure natriuresis in hypertensive patients and by comparing these curves to those observed in various forms of experimental hypertension of known origin, it is possible to gain insight into the etiology of this disease.

AB - In all forms of chronic hypertension, the renal-pressure natriuresis mechanism is abnormal because sodium excretion is the same as in normotension despite the increased blood pressure. However, the importance of this resetting of pressure natriuresis as a cause of hypertension is controversial. Theoretically, a resetting of pressure natriuresis could necessitate increased blood pressure to maintain sodium balance or it could occur secondarily to hypertension. Recent studies indicate that, in several models of experimental hypertension (including angiotensin II, aldosterone, adrenocorticotrophic hormone, and norepinephrine hypertension), a primary shift of renal-pressure natriuresis necessitates increased arterial pressure to maintain sodium and water balance. In genetic animal models of hypertension, there also appears to be a resetting of pressure natriuresis before the development of hypertension. Likewise, essential hypertensive patients exhibit abnormal pressure natriuresis, although the precise cause of this defect is not clear. It is likely that multiple renal defects contribute to resetting of pressure natriuresis in essential hypertensive patients. With long-standing hypertension, pathological changes that occur secondary to hypertension must also be considered. By analyzing the characteristics of pressure natriuresis in hypertensive patients and by comparing these curves to those observed in various forms of experimental hypertension of known origin, it is possible to gain insight into the etiology of this disease.

KW - Angiotensin

KW - Atrial natriuretic factor

KW - Blood pressure

KW - Essential hypertension

KW - Kidney

KW - Renin

KW - Sodium excretion

UR - http://www.scopus.com/inward/record.url?scp=0025288625&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025288625&partnerID=8YFLogxK

M3 - Review article

VL - 15

SP - 547

EP - 559

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 6 PART 1

ER -