[Role of hypothalamo-hypophyseal-adrenal axis in the pathogenesis of arterial hypertension in patients with prolactinoma of the anterior lobe of the hypophysis].

AIM

To elucidate mechanisms underlying arterial hypertension (AH) in patients with hyperprolactinemia, prolactin-secreting adenoma of the anterior lobe of the hypothesis, in particular.

MATERIAL AND METHODS

9 females with microprolactin-secreting and 4 females with macroprolactin-secreting adenoma of the anterior lobe of the hypophysis (mean age 33.8 +/- 3.7 years) were examined using radioimmunoassay of the hormones, computed tomography, MR-tomography of the adrenals and brain.

RESULTS

Humoral regulation of the hypothalamic-hypophyseal-adrenal axis was found different in patients with microadenoma due to dopaminergic insufficiency of the hypothalamus and in patients with macroadenoma--tumor of the hypophyseal genesis. Patients with microadenoma were diagnosed to have low-renin diastolic arterial hypertension with clinical symptoms of hyperaldosteronism and high levels of plasma aldosterone. Patients with macroadenoma had normal arterial pressure, aldosterone levels and plasma renin activity. Treatment with parlodel, agonist of dopaminergic receptors, reduced arterial pressure, prolactin level, plasma aldosterone and raised plasma renin activity in patients with microadenoma. Such changes were not observed in patients with macroadenoma.

CONCLUSION

It is suggested that one of the causes of AH in patients with microprolactin-secreting hypophyseal adenoma lies in hyperaldosteronemia which develops as a result of dopaminergic insufficiency of the hypothalamus and hyperprolactinemia.