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(Hypertension. 1996;28:421-425.)
© 1996 American Heart Association, Inc.

Articles

Ouabainlike Compound in Hypertension Associated With Ectopic Corticotropin Syndrome

Atsuo Goto; Kaoru Yamada; Hisanori Hazama; Yoshio Uehara; Keiichiro Atarashi; Yasunobu Hirata; Kenjiro Kimura; Masao Omata

the Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo, and Department of Human Dry Dock, Sanraku Hospital (K.Y.), Tokyo, Japan.

Molecular mechanisms related to sodium retention have been implicated in the pathogenesis of hypertension. It is unclear how sodium retention leads to a rise in blood pressure, but ouabainlike compound may act as a final common pathway in sodium-induced hypertension. In ectopic corticotropin syndrome, hypertension has been attributed to cortisol inactivation overload, giving rise to mineralocorticoid-type hypertension. We sequentially measured plasma and urinary levels of ouabainlike compound over 2 months to evaluate its role in the hypertensive mechanisms in a 64-year-old man with this syndrome caused by lung cancer. His data included hypokalemia and increased cortisol concentrations, corticotropin levels, and urinary 17-hydroxycorticosteroid excretion. Plasma renin activity was suppressed. Plasma and urinary levels of ouabainlike compound were markedly increased concomitantly with high blood pressure. The maximum plasma level was 40-fold the normal range of the subject. After chemotherapy, ouabainlike compound levels gradually decreased in parallel with the decline in blood pressure and rise in potassium concentration. A correlation was observed between plasma and urinary levels of ouabainlike compound (P<.05). Plasma and urinary levels of ouabainlike compound correlated with systolic (P<.01) and diastolic (P<.05) pressures, respectively. The peak of ouabainlike compound in plasma and urine coincided with that of authentic ouabain on high-performance liquid chromatography. Ouabainlike compound derived from urine inhibited [³H]ouabain binding to human erythrocytes. These findings suggest that ouabainlike compound with biological activity could partly account for hypertension in ectopic corticotropin syndrome.

Key Words: hormones • adrenocorticotropic hormone • Na⁺,K⁺-transporting ATPase • sodium-potassium pump • blood pressure • potassium • sodium

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