Prevention of salt angiotensin II hypertension by servo control of body water

An automated servo-control system to maintain total body weight constant was used to investigate the role of fluid volume expansion in the development of salt-dependent hypertension in dogs continuously infused with subpressor doses of angiotensin II. Dogs maintained on a fixed salt and water intake were studied in metabolic scale cages, which enabled continuous 24 h/day monitoring of changes in body weight as an index of changes in total body water. Beat-by-beat hemodynamics were determined 24 h/day. Daily fluid and electrolyte balances and hormonal profile were determined. Blood volume was periodically measured by injection of 51Cr red blood cells. After a 3-day control period, salt intake was increased from 8 to 120 meq/day. In contrast to the rise of arterial pressure that was observed in our previous nonservo-controlled volume studies, average 24-h mean arterial pressure, cardiac output, and total peripheral resistance remained unchanged during a 4-day high-salt period. Total body weight was maintained within 7 +/- 17 g of the original weight. Blood volume was unchanged by day 2 as indicated by direct measurement (51Cr red blood cells) or by analysis of plasma protein concentration. There was a retention of 82 +/- 5 meq (P less than 0.05) of sodium on day 1 of high-salt period. Plasma sodium concentration increased approximately 7 meq/l (P less than 0.05) above control levels. Plasma renin activity and aldosterone decreased to undetectable values, whereas vasopressin and atrial natriuretic peptide increased significantly. These results confirm that elevations of blood volume and cardiac output normally observed when salt intake was increased in dogs infused with angiotensin II are secondary to water retention and that this salt-dependent model of hypertension is dependent on fluid volume expansion.

Hemodynamics and blood volume in angiotensin II salt-dependent hypertension in dogs

The sequential effects of an increased daily NaCl intake on hemodynamics, fluid electrolyte balances, and hormonal responses were evaluated in dogs (n = 7) with fixed circulating levels of angiotensin II (ANG II). During the control period, ANG II was infused at 3 ng.kg-1.min-1 while dogs were maintained on an 8 meq NaCl/day diet. Water intake was fixed at 700 ml/day. Continuously recorded (24 h/day) changes of total body weight (TBW) were used as an index of total body water. Cardiac stroke volume and arterial pressure were recorded, and each beat was digitized to provide hourly and 24-h average cardiac output (CO), mean arterial pressure (MAP), and total peripheral resistance (TPR). After three stable control days, daily salt intake was increased to 120 meq for 7 days. TBW increased gradually to 448 +/- 111 g (2.9%, P less than 0.05) above control by day 3. An 11% expansion of blood volume (P less than 0.05) was found (51CR-labeled red blood cells) on day 2 of high NaCl. CO rose 12% and MAP 20% (P less than 0.05) in parallel with TBW by day 4. By day 7, CO remained only 5% elevated, whereas MAP had stabilized at 20% above control levels. TPR remained significantly elevated from days 3 through 7. A positive Na balance averaging 91 +/- 8 meq (P less than 0.05) occurred on day 1. Plasma Na concentration was increased 2-3 meq/l above control throughout the period of high-salt intake. Plasma renin activity and aldosterone levels decreased to nearly undetectable levels, vasopressin rose slightly, and atrial natriuretic peptide levels increased significantly. Dogs maintained at 8 meq/day NaCl during the same infusion of ANG II showed no changes in MAP, CO, TPR, or TBW. In summary, the salt-induced hypertension was consistently related to small but significant fluid retention, blood volume expansion, elevations of cardiac output, and a gradual increase in TPR.