Vascular responses to angiotensin II in Anorexia nervosa

      This paper is only available as a PDF. To read, Please Download here.


      Anorexia nervosa (AN) patients have a tendency to develop renin-angiotensin-aldosterone (RAA) abnormalities caused by abnormal behaviors expressed over long periods of time. Short-term dietary sodium intake is a known modulator of blood pressure response to infused angiotensin II (A II) in normal subjects. Therefore AN patients and normal gender-matched and age-matched controls were studied for vascular responses to exogenous A II. Untreated AN patients needed significantly greater quantities of exogenous A II to raise diastolic blood pressure (DBP) to over 20 mmHg for 30 min compared with controls (12.1 ± 0.47 versus 7.6 ± 0.69 ng/kg/min, p < 0.01). The amount of A II required to raise DBP to over 20 mmHg in AN patients in tests before and after completion of treatment (4.2 ± 0.33 months later) was significantly different (12.1 ± 0.47 versus 8.1 ± 0.25 ng/kg/min, p < 0.01). There was no significant difference between AN patients following treatment and controls. Our results indicate that it requires long time before decreased A II responsiveness caused by chronic sodium depletion normalizes in AN patients.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Aguilera G.
        • Catt K.
        Regulation of vascular angiotensin II receptors in the rat during altered sodium intake.
        Circ Res. 1981; 49: 751-758
        • Aguilera G.
        • Hauger R.L.
        • Catt K.J.
        Control of aldosterone secretion during sodium restriction: Adrenal receptor regulation and increased adrenal sensitivity to angiotensin II.
        in: Proc Natl Acad Sci USA. 75. 1978: 975-979
        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders. 3rd ed rev. American Psychiatric Press, Washington, DC1987: 65-67
        • Aro A.
        • Lamberg B.A.
        • Pelkonen R.
        Hypothalamic endocrine dysfunction in anorexia nervosa.
        Acta Endocrinol. 1977; 85: 673-683
        • Bartter F.C.
        • Pronove P.
        • Gill J.R.
        • Ross Met
        Hyperplasia of juxtaglomerular complex with hyperaldosteronism and hypokalemic alkalosis, a new syndrome.
        Am J Med. 1962; 33: 811-828
        • Brunner H.R.
        • Chang P.
        • Wallach R.
        • Sealey J.E.
        • Laragh J.H.
        Angiotensin II vascular receptors: their avidity in relationship to sodium balance, the autonomic nervous system, and hypertension.
        J Clin Invest. 1972; 51: 58-97
        • Dawson-Hughes B.F.
        • Moore T.J.
        • Dluhy R.G.
        • Hollenberg N.K.
        • Williams G.H.
        Plasma angiotensin II concentration regulates vascular but not adrenal responsiveness to restriction of sodium intake in normal man.
        Clin Sci. 1981; 61: 527-534
        • Elkington J.R.
        • Huth E.J.
        Body fluid abnormalities in anorexia nervosa and undernutrition.
        Metabolism. 1959; 8: 376-403
        • Fujita M.
        • Tamai H.
        • Mizuno O.
        • Nakagawa T.
        Secretory function of the renin-aldosterone system in patients with anorexia nervosa.
        Folia Endocrinol Jap. 1991; 67: 50-55
        • Gaillard R.C.
        • Favrod-Coune C.A.
        • Capponi A.M.
        • Muller A.F.
        Corticotropin-releasing activity of the renin-angiotensin system peptides in rat and in man.
        Neuroendocrinology. 1985; 4: 511-517
        • Gunther S.
        • Gimbrone Jr., M.A.
        • Alexander R.W.
        Regulation by angiotensin II of its receptors in resistance blood vessels.
        Nature. 1980; 287: 230-232
        • Health Promotion and Nutrition Division, Health service Bureau, Ministry of Health and Welfare
        Diagnostic Tables and Figures for Obesity and Emaciation.
        in: Daiichi press, Tokyo1986: 1-30 (In Japanese)
        • Hollenberg N.K.
        • Chenitz W.R.
        • Adams D.F.
        • William G.H.
        Reciprocal influence of salt intake on adrenal glomerulosa and renal vascular responses to angiotensin II in normal man.
        J Clin Invest. 1974; 54: 34-42
        • Iinuma K.
        • Arakawa Y.
        • Takagi A.
        • et al.
        A simplified radioimmunoassay for serum aldosterone—Non-extraction method with 125I-labeled aldosterone.
        Folia Endocrinol Jap. 1977; 53: 797-809
        • Kaplan N.M.
        • Silah J.
        The effect of angiotensin II on the blood pressure in humans with hypertensive disease.
        J Clin Invest. 1964; 43: 659-669
        • Kitamura M.
        • Nishina T.
        Practical Clinical Chemistry.
        in: Ishiyaku Press, Tokyo1982: 123-134
        • Komaki G.
        • Tamai H.
        • Mukuta T.
        • et al.
        Alterations in endothelium-associated proteins and serum thyroid hormone concentrations in anorexia nervosa.
        Br J Nutrition. 1992; 68: 67-75
        • Laragh J.H.
        • Angers M.
        • Kelly W.G.
        • Lieberman S.
        Hypotensive agents and pressor substances.
        JAMA. 1960; 174: 234-240
        • Matsubayashi S.
        • Tamai H.
        • Kobayashi N.
        • et al.
        Angiotensin-converting enzyme and anorexia nervosa.
        Horm Metab Res. 1988; 20: 761-764
        • Mizuno O.
        • Tamai H.
        • Fujita M.
        • et al.
        Aldosterone responses to angiotensin II in anorexia nervosa.
        Acta Psychiatr Scand. 1992; 86: 450-454
        • Ogihara T.
        • Nishi K.
        • Maruyama A.
        • et al.
        Determination of plasma renin activity using Gamma Coat [125I] PRA kits.
        Clin Endocrinol. 1980; 28 (Tokyo): 63-69
        • Platia M.P.
        • Catt K.J.
        • Hodgen G.D.
        • Aguilera G.
        Regulation of primate angiotensin II receptors during altered sodium intake.
        Hypertension. 1986; 8: 1121-1126
        • Schiffrin E.L.
        • Gutkomska J.
        • Genest J.
        Effect of angiotensin II and deoxycorticosterone infusion on vascular angiotensin II receptors in rats.
        Am J Physiol. 1984; 246: H608-H614
        • Shoback D.M.
        • Williams G.H.
        • Hollenberg N.K.
        • Davies R.O.
        • Moore T.J.
        • Dluhy R.G.
        Endogenous angiotensin II as a determinant of sodium-modulated changes in tissue responsiveness to angiotensin II in normal man.
        J Clin Endocr Metab. 1983; 57: 764-770
        • Takatsuki K.
        • Oiso Y.
        Disorders of fluid and electrolyte metabolism and their management in anorexia nervosa.
        JJPEN. 1987; 9: 313-316
        • Thurston H.
        • Laragh J.H.
        Prior receptor occupancy as a determinant of the pressor activity of infused angiotensin II in the rat.
        Circ Res. 1975; 36: 113-117
        • Trübestein von G.K.
        • Werning C.
        • Stadelmann O.
        • et al.
        Bartter und Pseudo-Bartter-Syndrom.
        Münch med Wschr. 1972; 114: 635-640
        • Uezono K.
        • Kawasaki T.
        • Ueno M.
        • Nakamuta S.
        • Omae T.
        The influence of age, sex, menstrual cycle and electrolyte balance on the renin-angiotensin-aldosterone system in normal subjects.
        Folia Endocrinol Jap. 1980; 56: 1618-1629
        • Vander A.J.
        Control of renin release.
        Physiol Rev. 1967; 47: 359-382
        • Warren M.P.
        • Wande Wiele R.L.
        Clinical and metabolic features of anorexia nervosa.
        Am J Obstet Gynecol. 1973; 117: 415-449
        • Williams G.H.
        • Hollenberg N.K.
        • Moore J.T.
        • et al.
        Failure of renin suppression by angiotensin II in hypertension.
        Circ Res. 1978; 42: 46-54
        • Wolff H.P.
        • Vecsei P.
        • Kruck F.
        • et al.
        Psychiatric disturbance leading to potassium depletion, sodium depletion, raised plasma-renin concentration and secondary hyperaldosteronism.
        Lancet. 1968; 1: 257-261