Increased Urine Vasopressin Concentration in Essential Hypertension

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BRIAN JOHNSON, CAROLE BYE, JUSTIN LABROOY,. DOUGLAS MUNRO-FAURE and JOAN SLACK. Department of Medicine, King's College Hospital,.
Medical Research Society

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from cerebral haemorrhage, renal failure and heart failure, but not myocardial infarction. One possible explanation is that some widely-used antihypertensive agents may have detrimental effects. 118 patients aged between 34 and 56 years were attending the Hypertension Clinic of King's College Hospital in April 1972. In 112, blood samples were obtained after fasting for 14 h. Electrocardiograms and creatinine clearance determinations were obtained within 6 months of blood collection. By comparison with a large series of matched control subjects, hypertensives did not have a significantly greater incidence of abnormal lipoprotein patterns of either Type I1 or IV. However, hypertensive women had a significantly higher mean triglyceride level, and densitometric measurement after agarose gel electrophoresis demonstrated a significant shift from beta to pre-beta lipoproteins in both male and female 20. INCREASED URINE VASOPRESSIN CON- hypertensives. Compared with other hypertensives, CENTRATION I N ESSENTIAL HYPERTENSION nineteen with previous vascular complications were significantly older, had a lower mean creatine clearA. M. & o m , C. HOUGH and J. D. H. SLATER Institute of Clinical Research, Middlesex Hospital ance, higher serum uric acid and more apparent beta to pre-beta lipoprotein shift. Thirty-seven Medical School hypertensives with electrocardiographic ST segment Defects of renal tubular water reabsorption have often depression were heavier smokers, had significantly been detected in patients with hypertension. We have higher initial pretreatment blood pressure, fasting reexamined this problem by measuring osmolar blood glucose and percentage prebeta lipoproteins, and free water clearance as well as urinary arginine and lower creatinine clearance and plasma cholesterol. vasopressin concentration in nine normal subjects and In women, uric acid levels were also significantly in ten patients under 45 years of age with mild to higher. Similar differences were observed between moderate systemic arterial hypertension. The subjects hypertensives with creatinine clearance above or have been studied (a) in their basal state, (b) after below 60 ml/min. Within hypertensives, pre-beta a 45" upright tilt, (c) after 18 h water deprivation, and lipoprotein percentage was positively correlated with after a water load (20 ml/kg). The results indicate serum triglyceride (r = 0.68), uric acid (037) and that urinary vasopressin concentration (AVP) in glucose (0.21), and triglyceride was correlated normal people is closely related to the osmolality with percentage ideal weight (0.24) and skinof the urine (U,,,) and that it becomes undetectable fold thickness (0.25). Creatinine clearance was when Uos, approaches that of the plasma osmolality. negatively correlated with initial blood pressure In hypertension the slope of the curve related U,,, (-0.28) and uric acid (-0.30). Heavy smokers had (abscissa)to urine AVP (ordinate) is steeper (P