[Compounds of the digoxin type in essential and experimental hypertension]

The prescription of cardiac glycosides is usually controlled by immunological measurement of their plasma concentration. The observation of false positive digoxin measurements in patients free of this drug and the hypothesis that endogenous digitalis-like compounds might participate in body sodium and water homeostasis have led us to investigate the presence in plasma of compounds interacting with digoxin-antibodies under various physiological and pathological conditions in man and rats. The apparent levels of digoxin-equivalents in plasma of healthy control subjects (n = 21) and patients with essential hypertension (n = 48) or end-stage renal failure (n = 13) were 24.7 +/- 3.2, 34.4 +/- 4.4 and 98.7 +/- 17.4 pg/ml, p less than 0.05 and p less than 0.01 respectively. Positive correlations were observed between systolic and diastolic blood pressure and the apparent immunoreactivity of either whole or deproteinized plasma, in particular when only male subjects were considered. No relationship was found with the renal Na+ excretion or the plasma renin activity and the apparent immunoreactivity of the plasma. Its levels were however correlated with its ability to inhibit ouabain binding to the erythrocyte Na+ pump and to its capacity to reduce the renal Na+, K+-ATPase activity. In rats with experimental hypertension, induced by chronic excess salt intake either alone or associated with reduced renal mass, the cross reactivity with antidigoxin antibodies was also enhanced when compared to control rats (71.6 +/- 10.2 pg/ml, n = 12 and 57.3 +/- 5.0 pg/ml, n = 33 respectively compared to 43.4 +/- 3.7 pg/ml, n = 36, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Canrenone: an effective antihypertensive in an experimental model of hypertension in which the active transport of sodium is diminished]

Recent studies in essential hypertensive patients and rats with genetic hypertension strongly suggested that the development of primary hypertension results from a transient and chronic "cascade" of events; I) excess Na+ intake, II) secretion of natriuretic factors, III) abnormal cell Na+ homeostasis in the vascular wall, due to the presence of inherited and induced abnormalities in different Na+ transport system and IV) increase in cytosolic free Ca2+ content and sympathetic drive. In vitro studies have previously shown that canrenone, an antihypertensive antialdosterone drug, behaves like a partial agonist at the digitalis-receptor site of the Na+, K+-pump. In particular, it has been shown that canrenone counterbalances the increases in internal Na+ and cytosolic free Ca2+ contents induced by ouabain in cultured smooth muscle cells. We thus investigated the effect of canrenone administration in a model of experimental hypertension with increased endogenous "ouabain-like" factors (rats with reduced renal mass under excess Na+ intake: RRM-salt rats). Results presented here confirm that RRM-salt rats exhibit: volume expansion, strongly decreased plasma renin activity, increased endogenous "ouabain-like" factors and (IV) decreased Na+, K+-pump activity and increased Na+ content in erythrocytes. In addition, we found that canrenone is antihypertensive in this model and this is associated with a tendency to normalize volume expansion, plasma levels of endogenous "ouabain-like" factors, Na+, K+-pump activity and Na+ content in erythrocytes. In conclusion, our results suggest that administration of canrenone to RRM-salt rats may induce a lowering of blood pressure by antagonism with endogenous "ouabain-like" factors at the vascular wall.

Active Na+ and Ca+ transport, Na+-Ca2+ exchange, and intracellular Na+ and Ca2+ content in young spontaneously hypertensive rats

The activity of Na+-Ca+-exchange and ATP-dependent Na+ and Ca2+ transport by heart sarcolemmal membranes from male 3-4-week-old spontaneously hypertensive rats (SHR) and their normotensive controls (WKY) were compared. Differences in active Ca2+ and Na+ transport between the two substrains were suppressed by addition of exogenous calmodulin. Calmodulin was active only in the presence of Ca2+. The rate of the Na+-dependent Ca2+ efflux, reflecting the activity of the Na+-Ca2+ exchange, was significantly higher in SHR than in WKY vesicles. An alteration of the intracellular calmodulin activity or content might thus be responsible for the modifications in Ca2+ handling, and limit the activity of the Na+ pump in SHR membranes. The platelet cytosolic free Ca2+ concentration of young SHR and WKY was measured by using the fluorescent indicator Quin-2/AM. In the absence or presence of added external Ca2+, no difference in the intracellular concentration of Ca2+ was observed between platelets of either origin. The intraerythrocytic sodium content, measured by flame spectrophotometry, was similar in SHR and WKY. This study, performed before the onset of hypertension, shows that membrane mechanisms controlling the intracellular ion content were already modified, whereas the resulting intracellular concentrations remained within the normal range.

Platelet cytosolic free calcium concentration in primary hypertension

Cytosolic free Ca2+ ([Ca2+]i) concentrations were measured in platelets from hypertensive and normotensive man and rat with the fluorescent indicator Quin-2/AM, taking into account the signal of the free chelator. In the absence of added external Ca2+, no difference in [Ca2+]i was observed between platelets of hypertensive patients and those of normotensive subjects or between platelets of spontaneously hypertensive rats (SHR; Okamoto-Aoki strain) and those of normotensive Wistar-Kyoto (WKY) rats. In the presence of 0.5-1 mmol/l external Ca2+, [Ca2+]i was higher in patients with essential hypertension than in their normotensive controls (250 +/- 14 versus 198 +/- 10 nmol/l; n = 30 and 36, P < 0.01). In SHR, platelet [Ca2+]i was higher than in WKY rats but did not change with age and blood pressure. Removal of external K+ or addition of 10(-4) mol/l ouabain were used to inhibit the Na+K(+)-pump. Whereas an increase in [Ca2+]i was observed in platelets from normotensives in the absence of external K+ (273 +/- 29 versus 197 +/- 9 nmol/l; n = 6; P < 0.05), no significant change in [Ca2+]i was observed after ouabain treatment (220 +/- 2 versus 203 +/- 22 nmol/l, n = 8). These results suggest that primary hypertension is accompanied by a disequilibrium between cellular Ca2+ influx, storage and extrusion. Such a characteristic, if present in other excitable cells and in particular in vascular smooth muscle cells, may play a major role in the increase in peripheral resistance. However, the relationship between Na(+)-pump inhibition and the rise in the intracellular calcium remains unclear.

Hypotensive action of canrenone in a model of hypertension where ouabain-like factors are present

It has been proposed that peripheral resistance can be increased by ouabain-like factors that are able to increase cell sodium and thereby cell calcium. Canrenone has been reported to be a partial agonist of ouabain. The effect of canrenone was investigated in rats with reduced renal mass (RRM) showing evidence of excess circulating ouabain-like factors. Wistar rats were uninephrectomized, 30% of the other kidney was removed, and they were given a 0.8% NaCl solution to drink. Half of them received 60 mg/kg per day of canrenone orally for 26 days. In RRM, the following indices of a ouabain-like activity were found: erythrocyte Na+K(+)-pump activity was decreased by 39% (P < 0.001), sodium content increased by 12% (P < 0.01), net erythrocyte sodium extrusion in plasma decreased by 20% (P < 0.01), and plasma digoxin equivalents increased by 62% (P < 0.02). Canrenone increased the IC50 for ouabain from 1.05 to 2.16 x 10(-4) mol/l (P < 0.05) in erythrocytes. In RRM with systolic blood pressure of 165 mmHg, acute administration of canrenone decreased blood pressure by 36 mmHg. Chronic administration blunted the blood pressure rise by 12, 26 and 21 mmHg at days 5, 14 and 26, respectively (P < 0.05). Haematocrit was markedly reduced in RRM (33%) and much less when treated with canrenone (37.5%). In conclusion, in contrast with spontaneously hypertensive rats, RRM hypertension is a model where a ouabain-like factor is present and in which canrenone reduces blood pressure. The hypotensive effect of canrenone may be related to a competition with ouabain-like factors.

[Circulating inhibitor of sodium active transport in essential hypertension and volemic expansion]

Circulating inhibitors of the Na+ pump have been proposed as participating in sodium excretion, extracellular and vascular volume regulation and as hypertensiogenic agents. The presence of digitalis-like compounds in human plasma has been investigated by measuring its ability to compete with tritiated ouabain for binding to the digitalis site of red blood cells. Their activities in plasma from either hypertensive or volume expanded patients were compared. High levels were found in plasma from 37 p. cent of the untreated patients with essential hypertension, 64 p. cent of patients with end-stage renal failure and 71 p cent of acromegalic patients in the hypersecreting phase. The patients of these two last classes have been selected as being normotensives and without family history of hypertension. An increased activity of the inhibitor should more likely be linked to the positive Na+ balance and the volemic expansion which characterise these last two diseases than to high blood pressure. The observations that the activity of the inhibitor is correlated with the plasma volume in acromegalic patients, it returns to normal values after hemodialysis in renal insufficiency or successful therapy of acromegaly and the decrease in its activity is proportional to the weight lost during dialysis in uremic patients, agree with this proposal.

[Chronic dietary sodium overload and release of a circulating Na+-K+ pump inhibitor]

High Na+ intake has been proposed to induce a rise in the activity of a circulating inhibitor of the Na+, K+-pump. The effects on male Wistar rats of a high sodium diet (8 per cent NaCl) on the activity of such a plasma Na+, K+-ATPase inhibitor were investigated. Systolic blood pressure, body weight, urinary Na+ excretion, haematocrit, intraerythrocytic Na+ content and the activity of a Na+ dependent transport system, i.e. the uptake of 5-HT by blood platelets were measured in parallel. After one week, neither systolic blood pressure nor intraerythrocytic Na+ content were modified, but the ability of the plasma extracts to inhibit renal Na+, K+-ATPase increased (70.9 +/- 1.7 vs 76.3 +/- 2.1 mumol Pi/mg/h; p = 0.05). After two weeks, the plasma inhibitory activity, the systolic blood pressure and the intraerythrocytic Na+ content were higher than that of control animals (65.5 +/- 1.6 vs 79.1 +/- 2.8 mumol Pi/mg/h, p less than 0.001; 132 +/- 2 vs 114 +/- 4 mmHg, p. +/- 0.001 and 4.95 +/- 0.32 vs 3.81 +/- 0.36 mmol/l.cells, p less than 0.05). After three months, the ability of plasma extracts to inhibit the Na+ pump and the systolic blood pressure were still elevated (57.8 +/- 1.8 vs 72.9 +/- 1.8 mumol Pi/mg/h, p less than 0.001; 145 +/- 4 vs 118 +/- 2 mmHg, p less than 0.001) whereas intraerythrocytic Na+ content had returned to control levels and 5-HT uptake was not modified.(ABSTRACT TRUNCATED AT 250 WORDS)

Calmodulin abolishes the changes in Ca2+ binding and transport by heart sarcolemmal membranes of spontaneously hypertensive rats

Both Ca2+ transport and binding properties of heart sarcolemmal membranes are altered in spontaneously hypertensive rats (SHR) when compared to their normotensive controls (WKY). The effects of calmodulin on these two processes were studied at free calcium concentrations presumed to be the physiological levels in the cytosol. At a calcium concentration of 2.10(-8)M, calmodulin did not significantly modify either binding or ATP-dependent accumulation of calcium by membranes of both origins. In contrast, at a free calcium concentration of 4.10(-7)M, calmodulin enhanced the calcium binding to SHR membranes and the ATP-dependent calcium transport by SHR and WKY membranes. Differences in calcium binding and ATP-dependent accumulation between the two substrains were suppressed in presence of calmodulin. These data demonstrate that modifications in calcium handling by SHR cardiac plasma membranes might be due to altered intracellular content or function of calmodulin in SHR.

Recent advances on endogenous Na+,K+-ATPase inhibitors: clinical investigation and purification

Evidence exists which demonstrates the relationship between a Natriuretic Factor or Na+,K+-ATPase inhibitor and volemic expansion, both in man and animal. Patients having extracellular volume expansion have been studied for the effect of their plasma on erythrocytes 3H-ouabain binding. High levels of ouabain-like activity was found in plasma from acromegalic patients and patients with chronic renal failure. High levels were also observed in some hypertensive patients. A partial purification of such a compound was performed from urine of hypertensives. The partially purified compound inhibited to a greater extent the Na+,K+-ATPase semi-purified from dog kidney than that from sheep brain. The present data are consistent with the possible regulation of the activity or the secretion of plasma ouabain-like activity by extracellular volume.

Altered active sodium and calcium transport by heart sarcolemmal membranes from young spontaneously hypertensive rats: modulation by calmodulin

Active transport of Na+,K+ and Ca2+ was compared in heart plasma membranes from 3-week-old spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). ATP-dependent Ca2+ accumulation, which reflects Ca2+, Mg2+-ATPase activity, was higher in SHR than in WKY membranes. At a free calcium concentration of 4 X 10(-7)M, the addition of 2 X 10(-7)M calmodulin enhanced the active Ca2+-transport more in WKY than in SHR vesicles. Na+- and K+-dependent ATPase activity was two fold higher in SHR than in WKY. From ouabain binding studies this seemed to be due to an increased density of enzyme units. Physiological concentrations of calmodulin and calcium ions reduced Na+,K+-ATPase activity in the two strains but more in SHR than in WKY. This study demonstrates that active Na+ and Ca2+ transport is enhanced in young SHR; the Ca2+-calmodulin complex may regulate Na+,K+-ATPase activity and sensitivity of Na+,K+-ATPase and Ca2+,Mg2+-ATPase activities to Ca2+-calmodulin differs between SHR and WKY.

Investigation of the endogenous Na+-pump inhibitor in essential hypertension and blood volume expansion

The digitalis-like activities of plasma extracts from 108 patients and normal subjects were measured by their ability to compete with ouabain for binding to the digitalis sites of the Na+-pump. High levels were found in 18 of 54 untreated patients with moderate hypertension, 10 of 14 patients with end-stage renal failure and six patients with active acromegaly. These levels returned to control values after dialysis in the patients with renal insufficiency and high levels of the inhibitor, and after successful surgery and cobalt therapy in seven acromegalic patients. An increase in circulating Na+, K+-ATPase inhibitor was also found in rats after chronic sodium loading. These results indicate that levels of the circulating compound with digitalis-like properties do not result from high blood pressure but, rather, are related to blood volume and Na+ balance.

Calmodulin reduces ouabain-sensitive ATPase of cardiac sarcolemmal membranes: high reduction in spontaneously hypertensive rats

Calmodulin and calcium effects on cardiac ouabain-sensitive adenosine triphosphatase (ATPase) activity were studied in young spontaneously hypertensive rats (SHR) and in their normotensive control Wistar-Kyoto rats (WKY). Cardiac sarcolemmal membranes from SHR showed significantly higher ouabain-sensitive ATPase activity than membranes from WKY rats. This activity was unaffected by calmodulin or calcium alone. However, when both calmodulin and calcium were added, ouabain-sensitive activity was significantly reduced without changes in the total ATPase activity. The calcium-dependent calmodulin effect was dose-dependent and greater in SHR than in WKY membranes. An altered interaction between the calcium-calmodulin system and sodium handling by the plasma membrane in SHR may play a role in the pathogenesis of hypertension.

Reduced platelet serotonin in depression

Platelet serotonin levels were measured in several psychiatric disorders to determine whether they distinguish among major depressive disorder (one or more depressive episodes and no manic episodes), dysthymic disorder (depressive neurosis), and schizophrenic and paranoid disorders. Serotonin levels in 141 subjects were determined using high performance liquid chromatography with electrochemical detection. Serotonin (5HT) levels in control subjects were significantly lower in males than in females. A marked reduction in 5HT levels, as compared to controls, was found in male and female patients with major depressive disorder, but not in dysthymic disorder. A slight but significant reduction in serotonin levels was found in female schizophrenic patients. The reduction in serotonin levels found in major depressive disorder could not be attributed to chronic antidepressant treatment. Liquid chromatography with electrochemical detection used in the present study permits a large-scale investigation.

[Circulating inhibitor of the Na+-K+ pump in essential hypertension. Physiological and pharmacological variations]

The presence of a circulating Na+ pump inhibitor has been assessed in 112 subjects by studying the effects of deproteinized plasma on ouabain binding to erythrocytes and/or inhibition of Na+-K+-ATPase activity. High levels of an inhibitor possessing some digitalis-like properties, were associated with essential hypertension, hypertensive heredity, treatment of hypertension with beta-blocking agents and high sodium intake. Low levels were found in hypertensives on diuretics, patients with chronic renal failure and normotensive controls. These observations are consistent with a possible role of this circulating inhibitor in the control of sodium balance and in hypertension.

[Active calcium and sodium transport by cardiac plasma membranes in the genetically hypertensive rat]

Active Na+ and Ca2+ transports by sarcolemmal vesicles from young spontaneously hypertensive rats (SHR) and their normotensive controls (WKY) were compared. The effects of the calmodulin and the calcium antagonist nifedipine on Ca2+ binding ATP-dependent accumulation of Ca2+ were studied at free Ca2+ concentrations of 2.10(-8)M and 4.10(-7)M. 2.10(-7)M calmodulin stimulated Ca2+ binding to SHR membranes up to a level equivalent to that in WKY, whereas it enhanced active Ca2+ transport more in WKY than in SHR, thus suppressing the difference between the two substrains. At a 2.10(-8)M free Ca2+ concentration low concentrations of nifedipine (10(-7) to 10(-6)M) induced an increases in ATP-dependent Ca2+ transport by SHR vesicles. Inhibition of NA+, K+-adenosine triphosphatase activity by ouabain was also studied. Na+, K+ATPase activity in SHR membranes was double that in membranes from WKY (22.1 +/- 2.8 v.s. 11.3 +/- 1.1. mumole Pi/h/mg protein). These differences, observed on 3 week-old rats, before a significant rise blood pressure, may reflect genetic characteristics of these hypertensive-prone rats.

Further analysis of cell membrane changes in genetic hypertension in rats by diphenylhexatriene fluorescence polarization

Fluorescence polarization of diphenylhexatriene embedded in membranes was used as an index of 'microviscosity' in platelets and erythrocyte ghosts of spontaneously hypertensive rats of the Okamoto-Aoki strain (SHR), Wistar-Kyoto strain (WKY) and of the hypertension-prone and -resistant Sabra strains (SBH and SBN ), and the original Sabra strain (SB). Microviscosity was increased both in erythrocyte ghosts and platelet membranes of male but not female SHR rats compared with WKY rats and in hypertension-prone Sabra rats compared with the original Sabra rats. Acute and chronic salt loading increased the microviscosity of platelet membranes in all strains of rats but had no effect on the erythrocyte membranes. Microviscosities of vesicles made of lipids extracted from SHR and WKY erythrocyte ghosts were similar. This supports the hypothesis that membrane proteins play a major role in the differences in microviscosity observed in SHR rats.

[Essential arterial hypertension, cellular intolerance to sodium]

Much experimental and clinical evidence points to the fact that increased intracellular Na+ concentration could play an important pathogenic role in hypertension, especially where cells of excitable tissues are concerned. Active extrusion of Na+ (from the cells to the extracellular space) depends mainly on the activity of the system of membrane transport known as the Na+ pump. The extrusion of Na+ occurs in exchange for K+ and the activity of the pump depends on the enzyme Na+-K+-ATPase. The Na+ pump is inhibited by cardiotonic glycosides such as digitalis and ouabain . The results obtained in our laboratory suggest that the activity of the Na+ pump is controlled by an endogenic system acting in a similar manner to ouabain and digitalis. Experimental and clinical studies show: -- that the administration of Na+ increases the inhibitor effect both in urine and plasma; -- that the inhibitor is increased in about 50 p. 100 of patients with essential hypertension; -- that this increase seems to depend on familial or genetic factors. The biochemical identification of this endogenic inhibitor is now under way; it has a small molecular weight (less than 3000), is thermostable and anionic. This factor could have both a regulating role on Na+ turnover and a pathological role in hypertension. Its activity comes into competition cations also capable of inhibiting the Na+ pump, including K+.

Quantitative changes in cardiac Na+, K+ -adenosine triphosphatase of spontaneously hypertensive rats

Sodium pumps of cardiac plasma membranes were studied in young, spontaneously hypertensive rats (SHR) and in their normotensive controls (Wistar-Kyoto; WKY) using the two following methods. The enzymatic activity and its sensitivity to ouabain were measured as the Na+, K+ -dependent ATP hydrolysis, and the number of pumps was estimated by [3H] ouabain binding. The main results of this study were the observations that (a) concentrations of ouabain as low as 10(-10) M inhibited 10-15% of the enzyme activity in both strains; (b) Na+, K+- adenosine triphosphatase (ATPase) activity in membranes from SHR was double that in membranes from WKY (16.5 +/- 3.2 mumol Pi/h/mg protein vs. 8.2 +/- 1.2 mumol Pi/h/mg protein for 10(-7) M ouabain; p less than 0.01); (c) sensitivity to three different cardiac glycosides, ouabain, digoxin, and digitoxigenin, was identical in SHR and WKY vesicles; and (d) the binding capacity of [3H] ouabain was significantly higher in SHR than in WKY vesicles, but the dissociation constant (KD) did not appear to differ between the two substrains. These studies, performed on 3-week-old rats before the appearance of hypertension, showed, on the one hand, the existence of a Na+, K+ -ATPase of very high affinity in the rat heart, and, on the other, that cardiac sarcolemmal membranes from SHR had a greater number of sodium pumps than those from WKY and thus a greater ability to extrude sodium.

Central hypertensive effect of ouabain in rats

Ouabain was infused into the third cerebral ventricle of fully conscious, pentobarbital-anaesthetized or urethane-anaesthetized rats. Convulsive seizures occurred in the freely moving rats. The blood pressure of the pentobarbital-anaesthetized rats rose inconsistently. However, in those animals, anaesthetized with urethane, a consistent cardiovascular response was observed with an initial bradycardia, followed by a progressive increase in both the blood pressure and the heart rate. The hypertension was associated with a rise in the CSF potassium level. Tachyphylaxis to these responses was observed.

Stimulation by nifedipine of calcium transport by cardiac sarcolemmal vesicles from spontaneously hypertensive rats

The effects of the calcium antagonist nifedipine on the binding and ATP-dependent accumulation of calcium by cardiac plasma membranes from spontaneously hypertensive rats (SHR) and from their normotensive controls (WKY) were studied at free calcium concentrations of 2 X 10(-8) M and 4 X 10(-7) M corresponding to very high affinity and high affinity binding sites respectively. Nifedipine did not significantly modify calcium binding to either class of sites in SHR or WKY membranes. In contrast, in a free calcium concentration of 2 X 10(-8) M, nifedipine enhanced ATP-dependent Ca2+ transport. The concentration of nifedipine required for significant stimulation was smaller in SHR than in WKY membranes (10(-7) M and 10(-5) M respectively). Another calcium antagonist, D600, did not modify ATP-dependent calcium accumulation by SHR or WKY vesicles. These results raise the question of the mechanism of action of nifedipine on the calcium pump and confirm the presence of abnormalities in cardiac plasma membranes from young SHR, rendering them more sensitive than WKY membranes to the calcium antagonist nifedipine.

Plasma sodium pump inhibitor in essential hypertension and normotensive subjects with hypertensive heredity

The presence in plasma extracts of a sodium pump inhibitor with digitalis-like properties was investigated by two complementary tests: decrease in the affinity of ouabain binding to human red blood cells and inhibition of Na+,K+-ATPase. The results of the two methods were correlated (r = 0.76, n = 44, p less than 0.01), suggesting that the same factor may be responsible for both effects. All subjects with elevated values were hypertensive or normotensive and had a family history of hypertension. Forty percent of the subjects in these two groups had high inhibition values. The elevation was significant (p less than 0.01) when compared with values in normotensive subjects with no hypertensive heredity. Increased inhibition was observed in patients taking beta-blocking agents; conversely, diuretics normalized the values. No correlation was found between pump inhibition and age, sex, blood pressure, levels of plasma K+ or Na+, or plasma renin activity. These data show the existence of a sodium pump inhibitor in the plasma of some subjects and point to a possible association with hypertension. They also underline the importance of genetic background and the heterogeneity of essential hypertension.

Cell membrane changes after in vivo acute Na+ load in normotensive and spontaneously hypertensive rats

Our previous observation of a greater increase in erythrocyte Na+ in SHR than in WKY after an acute Na+ load may result either from a genetic membrane property or from a specific plasma influence. In order to elucidate this question, membrane characteristics were compared with or without an acute Na+ load. Na+ transport was measured in Ringer and in plasma on Na+ enriched and K+ depleted red cells. Platelet microviscosity was measured as an index of membrane structural changes. After acute Na+ load a similar reduction of net Na+ extrusion and of K+ influx was observed in both strains. This indicates an inhibition of the Na+,K+-pump. Platelet microviscosity was similarly increased in SHR and WKY. Thus an acute Na+ load induced alterations of membrane properties in both SHR and WKY. The higher erythrocyte Na+ content in SHR stems rather from their intrinsic membrane properties than from a plasma factor.

Circulating digitalis-like compounds in essential hypertension

Inhibitors of the Na+ pump have been proposed as participating in sodium excretion, extracellular fluid regulation, and in the rise of blood pressure. The presence of digitalis-like compounds in human plasma has been investigated by comparing the effects of plasma extracts to those of ouabain in 4 tests. - competition with ouabain for binding to the Na+ pump, - inhibition of Na+ and K+ dependent hydrolysis - inhibition of serotonin uptake by human platelets - central hypertensive effect Plasma fractions exhibited digitalis-like properties in the 4 tests. The effects of plasma extracts of 42 normotensive subjects (21 with family history of hypertension) and 38 patients with essential hypertension (15 with antihypertensive treatment) and 9 patients with chronic renal failure were compared. Plasma from Forty per cent of untreated hypertensive patients and normotensives with hypertensive heredity had a high inhibition level. Inhibition was enhanced in beta-blocker treated patients and decreased in those on diuretics. No digitalis-like activity was observed in uremic plasma. These observations strongly suggest the presence of digitalis-like compound(s) in human plasma and point to its possible association with hypertension.

[Chronic sodium loading and circulating inhibitor of Na+,K+-ATPase in rats]

The effects of chronic sodium load on the activity of a circulating inhibitor of the Na+, K+-pump were measured in male Wistar rats. The inhibition by deproteinized plasma of renal Na+, K+-ATPase was higher in rats with high Na+ intake than in control animals (53.4 +/- 2.0 mumoles Pi.h-1 X mg-1 vs 66.6 +/- 2.6 mumoles Pi.h-1 X mg-1, p less than 0.01). The simultaneous rise in systolic blood pressure and the decrease in the hematocrit suggest that blood pressure, volemic expansion and the activity of this inhibitor may be somehow linked.