Romagni et al. [
[1]
] in their recent double blind placebo controlled cross over study, looking at non-genomic
vascular effects of aldosterone, found potent constriction (nearly 70%) in the forearm
resistance vasculature, in response to intrabrachial aldosterone. This is comparable
to the vasoconstriction induced by endothelin in the forearm resistance bed [
[2]
]. Furthermore, this may have underestimated the magnitude of the effect because it
did not appear to have reached a plateau at the end of the 10 min infusion period. In a similar dose response study we observed no changes in forearm
blood flow [
[3]
]. Why these conflicting data? We note that there were important differences in the
subject characteristics at baseline between the two studies. The basal plasma aldosterone
was high in the former (means of 189 and 175 pg/ml) which is within the range for mild to moderate heart failure with ‘aldosterone
escape’ [
[4]
], whereas in our study the basal plasma aldosterone was 113 pg/ml. The 24 h urine Na+ was also rather elevated (means of 161 and 159 mmol/24 h), reflecting a state of sodium excess, compared with 137.8 mmol/24 h in our study. We speculate that these differences in sodium status may be responsible
for the very different findings in the two studies.- Cicoira M.
- Zanolla L.
- Franceschini L.
- Rossi A.
- Golia G.
- Zeni P.
- et al.
Relation of aldosterone “escape” despite angiotensin-converting enzyme inhibitor administration
to impaired exercise capacity in chronic congestive heart failure secondary to ischemic
or idiopathic dilated cardiomyopathy.
Am. J. Cardiol. 2002; 89: 403-407
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References
- Aldosterone induces contraction of the resistance arteries in man.Atherosclerosis. 2003; 166: 345-349
- Repeatability of local forearm vasoconstriction to endothelin-1 measured by venous occlusion plethysmography.Br. J. Clin. Pharmacol. 2002; 54: 386-394
- Lack of rapid aldosterone effects on forearm resistance vasculature in health.J. Renin. Angiotens. Aldoster. Syst. 2002; 3: 123-125
- Relation of aldosterone “escape” despite angiotensin-converting enzyme inhibitor administration to impaired exercise capacity in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy.Am. J. Cardiol. 2002; 89: 403-407
Article Info
Publication History
Received:
June 5,
2003
Identification
Copyright
© 2003 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
