The metabolic clearance of aldosterone decreases similarly during infusion of angiotensin II in patients with essential hypertension and in normal subjects.

To determine if the abnormally large increases in levels of plasma aldosterone which occur during infusion of angiotensin II in some patients with essential hypertension are due to abnormal decreases in the metabolic clearance of aldosterone, we measured clearances of aldosterone before and during infusion of angiotensin II in 12 patients with essential hypertension and in 10 normal subjects. The metabolic clearance of aldosterone in the patients and that in the normal subjects were the same before angiotensin II was infused and the clearances decreased similarly during infusion of angiotensin II. In agreement with our previous observations, the plasma aldosterone responses to angiotensin II were greater than normal in most of the patients with low renin essential hypertension. Thus, the brisk increases in levels of plasma aldosterone during infusion of angiotensin II in patients with essential hypertension reflect abnormally large increases in the secretion of aldosterone. These results add further support to the idea that adrenal sensitivity to angiotensin II is increased in some patients with essential hypertension.