Plasma 19-hydroxyandrostenedione is elevated in patients with high renin essential hypertension.

We have reported that 19-hydroxyandrostenedione (19-OH-A-dione) functions as an amplifier of the sodium-retaining and hypertensive action of aldosterone. We therefore measured 19-hydroxyandrostenedione in hypertensive patients. We studied 53 normal male control subjects and 63 male patients with essential hypertension (48 patients with normal renin essential hypertension and 15 patients with high renin essential hypertension). Plasma 19-OH-A-dione levels were measured by RIA. Plasma 19-OH-A-dione concentrations in control subjects and patients with normal and high renin essential hypertension were 115 +/- 46 (mean +/- SD), 112 +/- 49 and 201 +/- 79 pmol/l, respectively. Patients with high renin essential hypertension showed significantly higher 19-OH-A-dione concentrations than did control subjects. The evaluation of the correlation between plasma 19-OH-A-dione concentrations and plasma renin activity revealed that plasma 19-OH-A-dione concentrations in hypertensive subjects rose gradually with an increase in plasma renin activity. Therefore, a significant correlation was found between plasma renin activity and plasma 19-OH-A-dione (r = 0.586, P < 0.001). In contrast, in control subjects, no significant correlation was found between plasma renin activity and plasma 19-OH-A-dione (r = 0.059, P > 0.05). The secretion of 19-OH-A-dione from the adrenal cortex is under the control of the renin-angiotensin system in hypertensives but not in normotensives.