Heterogenous Blood Pressure Response to Furosemide in Patients with Primary Aldosteronism

Hypertension associated with primary aldosteronism (PA) is generally regarded as saltsensitive [1,2]. However, a recent study has shown that patients with PA had a heterogenous blood pressure response to dietary sodium loading [3]. In this study we aimed to classify patients with PA in terms of blood pressure responsiveness to furosemid, and further characterize the hypotensive and metabolic responses to angiotensin- converting enzyme inhibitor (ACEI). Twenty-one patients with primary aldosteronism (mean age: 40 years) were enrolled in the study. All were proved to be aldosteronoma by pathologic examination of excised adrenal tumors. The study was performed before operation with regular sodium intakes. Antihypertensive medications were with drawn at least 2 weeks prior to the study. Furosemide was administered in a dose of 20 mg intravenously. Measurement of blood pressure, heart rate, urine output and collection of blood samples were done hourly before and after furosemide administration for 3 h. Captopril test was performed similarly except that 100 mg of captopril was given by the oral route. Plasma renin activity and plasma aldosterone concentration were measured by radioimmunoasaay metods. Serum and urine sodium and potassium concentrations were determined by an autoanalyzer. Mean blood pressure (MBP) was calculated by adding one third of the pulse pressure to the diastolic pressure. Student 's test was used for statistical calculation.#0482