Effects of ACTH and cortisol administration on blood pressure, electrolyte metabolism, atrial natriuretic peptide and renal function in normal man
Abstract
Both Adrenocorticotrophin (ACTH) and glucocorticoids raise blood pressure in man and animals, but the relationship of this and altered renal function to other cardiovascular variables, and the differences and similarities of the effects of the two agonists have not been fully explained. The present study compares the effects of ACTH (0.5 mg i.m; every 12 h) and cortisol (50 mg orally, every 6 h) in six normal men over a period of 5 days, preceded and followed by control periods of 3 and 2 days, respectively. Plasma cortisol levels were higher during ACTH treatment than during cortisol treatment. Both treatments raised blood pressure significantly and caused a marked antinatriuresis and expansion of extracellular fluid and plasma volume. ACTH also enhanced potassium excretion but this was less obvious for cortisol. Plasma concentrations of atrial natriuretic peptide rose to more than twice the basal level with both treatments. Both treatments markedly altered renal function. They raised glomerular filtration rate (GFR), i.e. inulin clearance (141% with ACTH; 113% with cortisol) although creatinine clearance was not changed, showing this to be an unreliable index during steroid administration. Filtration fraction (FF) also increased during both treatments, and renal blood flow (RBF) fell, although this achieved statistical significance only during cortisol treatment. Effective renal plasma flow [para-amino hippurate (PAH) clearance] remained unchanged while calculated renal vascular resistance increased. Fractional sodium reabsorption also rose but achieved statistical significance only during ACTH treatment. The similarity of response to treatment suggests that cortisol is largely responsible for the effects of ACTH.(ABSTRACT TRUNCATED AT 250 WORDS)
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Chronic high circulating levels of ACTH, caused by excess anterior pituitary secretion such as Cushing's disease or by infusion of ACTH, are associated with hypertension in humans and experimental animals.
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From Role of the brain melanocortins in blood pressure regulation (2017) · cites this paper as [10]
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“hypothalamus-pituitary-adrenal cortex system and releases catecholamine, cortisol, vasopressin, endorphins, and aldosterone leading to BP elevation (Connell et al., 1987; Whitworth et al., 1984; Willard et al., 1969; Lu et al., 2000).”
BackgroundThe role of hormones in renal disease and ischemia-reperfusion injury.
Banaei, S., & Rezagholizadeh, L. (2019) · PubMed · doi:10.22038/ijbms.2019.34037.8095 · Cited by 19 · see citing works
“Cortisol enhances the capacity of the kidney to regulate fluid and electrolyte homeostasis by raising GFR and delivering more water and sodium to the distal nephron where the reabsorption of water and sodium is regulated in accordance with need (23).”
BackgroundMartı́nez, N. I., Panciera, D. L., Abbott, J. A., et al. (2004) · Research in Veterinary Science · doi:10.1016/j.rvsc.2004.05.004 · Cited by 19 · see citing works
“No significant differences in the concentrations of epinephrine or norepinephrine were found in normal humans treated with hydrocortisone.(14,41) In addition, plasma neuropeptide Y (NPY) concentration, a sympathetic co-transmitter, is not elevated in normal humans after cortisol administration.”
BackgroundInfluentialEFFECTS OF INDOMETHACIN ON STEROID‐INDUCED CHANGES IN PRESSOR RESPONSIVENESS IN MAN
Whitworth, J. A., Connell, J., Gordon, D., et al. (1988) · Clinical and Experimental Pharmacology and Physiology · doi:10.1111/j.1440-1681.1988.tb01078.x · Cited by 19 · see citing works
“1986; Connell et al. 1987).”
BackgroundSelf-citationInoue, M., Okamura, K., Kitaoka, C., Kinoshita, F., Namitome, R., Nakamura, U., Shiota, M., Gotō, K., Ohtsubo, T., Matsumura, K., et al. (2018) · Endocrine Journal · doi:10.1507/endocrj.ej18-0025 · Cited by 18 · see citing works
“How‐ ever, from the clinical point of view, it has been clearly shown that administration of glucocorticoid in healthy volunteers has very little effect on serum catecholamine levels [48].”
BackgroundCarroll, D., Phillips, A. C., Lord, J. M., Arlt, W., & Batty, G. D. (2011) · Journal of Human Hypertension · doi:10.1038/jhh.2011.6 · Cited by 18 · see citing works
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Our Own Worst Enemy: Pharmacologic Mechanisms of Hypertension
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“Cortisol at doses of 80 to 200 mg/d can increase SBP by 15 mm Hg within 24 hours(8) and peaks at day 4 or 5.(9) The classic explanation of this blood pressure elevation is stimulation by cortisol of themineralocorticoid receptor resulting in kidney sodium retention and increased volume.”
BackgroundThe glucocorticoid receptor and hypertension
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The Safety of Low-Dose Glucocorticoids in Rheumatic Diseases: Results from Observational Studies
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EFFECTS OF CORTISOL ON BLOOD PRESSURE AND SALT PREFERENCE IN NORMAL HUMANS
Wong, K. S., Williamson, P. M., Brown, M. A., Zammit, V. C., Denton, D. A., & Whitworth, J. A. (1993) · Clinical and Experimental Pharmacology and Physiology · doi:10.1111/j.1440-1681.1993.tb00584.x · Cited by 16 · see citing works
Self-citationNEUROPEPTIDE Y IN CORTISOL‐INDUCED HYPERTENSION IN MALE VOLUNTEERS
Whitworth, J. A., Williamson, P. M., Brown, M. A., & Morris, M. J. (1994) · Clinical and Experimental Pharmacology and Physiology · doi:10.1111/j.1440-1681.1994.tb02538.x · Cited by 16 · see citing works
“This pattern during cortisol administration is very similar to what we have previously observed in other studies in which noradrenaline and adrenaline concentrations were measured (Connell et al. 1987) but there was no increase in these catechols during cortisol withdrawal (Connell et al.”
BackgroundResultInfluentialSelf-citationHemodynamic profile of corticotropin-induced hypertension in the rat
Cheng, W., Fraser, T. B., Li, M., et al. (1998) · Journal of Hypertension · doi:10.1097/00004872-199816020-00009 · Cited by 16 · see citing works
Self-citationAdministration of dexamethasone induces proteinuria of glomerular origin in mice
Chen, A., Sheu, L. F., Ho, Y., et al. (1998) · American Journal of Kidney Diseases · doi:10.1053/ajkd.1998.v31.pm9506681 · Cited by 15 · see citing works
Hu, J., Chen, J., Cheng, Q., et al. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.784706 · Cited by 15 · see citing works
“5mg every 12h for five days markedly raised blood pressure in normal man (24).”
Background
- Authors
- Connell, J. M. C., Whitworth, J. A., Davies, D. L., Lever, A. F., Richards, A. M., & Fraser, R.
- Affiliations
- Western Infirmary (GB)
- ORCID
- Davies, David L.
- Venue
- Journal of Hypertension
- Published
- 1987-08
- Volume
- 5
- Issue
- 4
- Pages
- 425???434
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W2002017042
- Cited by
- 188
- References
- 0
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 3 · 2022: 2 · 2021: 6 · 2020: 4 · 2019: 5 · 2018: 7 · 2017: 10 · 2016: 7 · 2015: 8 · 2014: 8 · 2013: 3 · 2012: 10
- FWCI
- 4.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- ACTH, cortisol, glucocorticoids, blood pressure, antinatriuresis, extracellular fluid expansion, plasma volume, potassium excretion, atrial natriuretic peptide, renal function, glomerular filtration rate, filtration fraction, renal blood flow, renal vascular resistance, sodium reabsorption, electrolyte metabolism
- MeSH terms
- Adrenocorticotropic Hormone, Adult, Blood Pressure, Electrolytes, Extracellular Space, Hemodynamics, Humans, Hydrocortisone, Kidney, Male, Middle Aged, Natriuresis, Atrial Natriuretic Factor, Renin-Angiotensin System
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