September 1971

Saline Suppression of Plasma Aldosterone in Hypertension

Author Affiliations

USA, Honolulu; Indianapolis; Honolulu; Tucson, Ariz

From the departments of internal medicine, Tripler Army Hospital, Honolulu (Dr. Kem); the Indiana University Medical Center, Indianapolis (Dr. Weinberger); the University of Hawaii School of Medicine, Honolulu (Mr. Mayes); and the University of Arizona College of Medicine, Tucson (Dr. Nugent). Dr. Kem is now with the University of Texas Southwestern Medical School, Dallas. Mr. Mayes is now with the Inter-Science Institute, Los Angeles.

Arch Intern Med. 1971;128(3):380-386. doi:10.1001/archinte.1971.00310210056004

Nine normal subjects and 18 patients with essential hypertension had similar suppression of plasma aldosterone concentration to 5 ng/100 ml or less after intravenous infusion of 2 liters of isotonic saline during four hours of recumbency. Six patients with aldosteronism and adrenal adenomas or glucocorticoid suppressible hyperplasia failed to suppress normally. One hypertensive hypokalemic patient with low plasma renin activity had elevated plasma deoxycorticosterone and failed to suppress his plasma aldosterone concentration below 5 ng/100 ml. Three of four patients with renovascular stenosis and hypertension suppressed normally. The fourth patient with a postinfusion plasma aldosterone concentration of 7 ng/100 ml was found to suppress normally when this value was expressed as percent of the two-hour upright value. This saline infusion, recumbency test is rapid and requires minimal patient preparation.