[A case of arterial hypertension imputable to an estroprogestational contraceptive. Implication of the renin-angiotensin-aldosterone system]
- PMID: 4314141
[A case of arterial hypertension imputable to an estroprogestational contraceptive. Implication of the renin-angiotensin-aldosterone system]
Abstract
PIP: A 44-year old woman without history of hypertension in her 4 pregnancies was hospitalized for hemoptysia and found to have hypertension 230/120 to 250/150: she had been taking 2 tablets of Lyndiol (5 mg lynestrenol and .15 mg mestranol) daily for 2 years without medical supervision. Findings included: hypokalemia (2.5 mEq/1), hyperchloremia (105 mEq/1), elevated aldosterone excretion (27 m cg/24 hours), low plasma renin activity (5 ng/1/minute). The initial diagnosis of an aldosterone secreting tumor was discarded and the oral contraceptive incriminated when her blood pressure fell, her lab finding normalized and she lost 3 kg within 6 weeks while on a normal diet. Several weeks after her blood pressure had remained 140/80 to 150/90, she was hospitalized again and given 2 tablets of Lyndiol daily while consuming a diet of 100 mEq sodium per day. The only change was a definite increase in plasma renin substrate from 1300-2300 ng/ml. The authors suggested that the hypertension observed in some pill users is due to hyper-aldo-steronism not resulting from stimulation of the renin-angiotensin system.
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