Aldosterone production during dietary sodium restriction and beta-adrenergic blockade

The role of the renin-angiotensin system in mediating the aldosterone response to sodium depletion was examined by administration of propranolol during dietary sodium restriction. The beta-adrenergic antagonist prevented the expected increase of plasma renin activity in response to sodium restriction in six of twelve studies. Plasma angiotensin II concentration failed to increase in four of five subjects in whom the renin response was abolished. Despite unchanged or decreased plasma renin activity and plasma angiotensin II concentration, plasma aldosterone concentration increased significantly in response to dietary sodium restriction. The increase in aldosterone production could not be attributed to changes in plasma sodium or potassium concentration or increased ACTH secretion. It is suggested that the aldosterone response to sodium restriction is mediated not only by increased plasma renin activity and angiotensin II concentration, but also another mechanism, possibly related to increased adrenal sensitivity to angiotensin during sodium depletion.