• Edward G. Biglieri


In recumbent man, the periodicity of adrenocorticotropin (ACTH) and plasma renin activity (PRA) is well established—a daytime downward drift with an early-morning surge. In upright man, however, the patterns differ. Although the circadian rhythm of ACTH and its effect on corticosteroids persists regardless of position, assumption of upright posture in daytime causes an increase in PRA, resulting in a biphasic pattern. The rhythms of ACTH-dependent steroids, cortisol, corticosterone, and deoxycorticosterone remain unchanged regardless of posture. In addition, aldosterone has an ACTH-dependent pattern when PRA is fixed or virtually inoperative during recumbency. However, with assumption of upright posture after overnight recumbency, the increase in PRA produces a peak in plasma aldosterone concentration and this results in a biphasic plasma aldosterone response to upright posture. During recumbency, the early-morning surges of ACTH and PRA seem to be closely related. However, with assumption of upright posture, there is clear separation between the increase in PRA and the diminishing ACTH effect that usually occurs between 8:00 A.M. and 12:00 noon, when most postural studies are undertaken.1


Plasma Renin Activity Congenital Adrenal Hyperplasia Primary Aldosteronism Renovascular Hypertension Total Blood Volume 
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Copyright information

© Springer Science+Business Media New York 1979

Authors and Affiliations

  • Edward G. Biglieri
    • 1
    • 2
  1. 1.Department of MedicineUniversity of California School of MedicineSan FranciscoUSA
  2. 2.Endocrine Division of Medical ServiceSan Francisco General Hospital Medical CenterSan FranciscoUSA

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