Humoral factors and the sodium-potassium pump in volume expanded hypertension.

Bioassay studies in the old and recent literature suggest the presence of an unknown slowly acting pressor agent in the blood of animals and man with volume expanded (low renin) hypertension. Recent studies in our laboratories suggest that the sodium-potassium pump activity of blood vessels is suppressed in animals with one-kidney, one wrapped, one-kidney, one clip, and one-kidney, DOCA, salt hypertension. Similar reduction of Na⁺, K⁺-ATPase activity has been observed in the left ventricle of animals with one-kidney, one clip and one-kidney, DOCA salt hypertension. The changes do not appear to result from increased pressure since they have also been observed in veins and right ventricle. Acute volume expansion of the normal rat with saline suppresses pump activity in the tail artery and plasma from these animals suppresses pump activity when applied to a tail artery from another rat. Data in the literature indicate that the adrenergic nerve terminals are depleted of norepinephrine. Suppression of pump activity, with ouabain for example, is known to activate cardiovascular muscle and reduce norepinephrine uptake by nerve terminals. These observations suggest a role for a slowly acting ouabain-like humoral agent, which acts directly on cardiovascular muscle to increase contractility and on nerve endings to reduce reflex compensation, in the genesis of volume expanded hypertension.