Abstract
The corticosteroids are essential for the maintenance of normal blood pressure. Adrenal insufficiency is characterized by hypotension. In susceptible species excesses of all known corticosteroids can cause hypertension. The adrenal cortex is to some degree a “permissive” sustaining factor in many types of hypertension as first established in renal hypertension by Goldblatt (1934). Adrenal dysfunction is the apparent primary cause of some uncertain but significant fraction of hypertensive disease in man. It follows, therefore, that “chemical adrenalectomy” by the use of drugs or competitive antagonists of adrenal steroids could have a role in the therapeutic management of high blood pressure. This is indeed the case but that this role of the adrenal cortical inhibitors is at present a relatively minor one is due to a combination of (a) etiologic uncertainties concerning conditions logically calling for their use, (b) lack of highly specific drugs for such use, and (c) the metabolic ingenuity of the adrenal in thwarting attempts to alter its complex secretory functions in accordance with man-made concepts of desirable ends.
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Gaunt, R., Melby, J.C. (1977). The Pathophysiology of Adrenal Inhibitors with Respect to their Antihypertensive Activity. In: Gross, F. (eds) Antihypertensive Agents. Handbuch der experimentellen Pharmakologie / Handbook of Experimental Pharmacology, vol 39. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-66309-3_10
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