[Strategy for hormonal study in the arterial hypertension of acromegaly]

High blood pressure occurs in about 25 p. 100 of acromegalic patients. The mechanisms involved are unknown but an unusual incidence of Conn's syndrome has been reported in acromegaly. The development of hypertension may be favored by the chronic hydro-saline inflation dependent upon the growth hormone excess. Sodium inflation is likely to be responsible for abnormal responses to angiotensin II and its antagonists in normotensive acromegalics, which make the use of these agents inappropriate for the study of the renin-angiotensin-aldosterone system. The latter can be profitably explored by the measurement of hormonal blood levels which increase normally in response to Na deprivation and orthostatism. In cases of associated Conn syndrome, the urinary level of tetrahydro-aldosterone may be normal, aldosterone being metabolized through other pathways. This appears to be independent to growth hormone hypersecretion.