Blood-Pressure Hormone

Although medical science still cannot pinpoint a cause for the vast majority of cases of high blood pressure, researchers are gradually narrowing the area of uncertainty. More and more cases can be effectively treated because they have been traced to disease of the kidneys or their arteries. Last week in the A.M.A. Journal. the University of Michigan's Dr. Jerome W. Conn reported that one form of high blood pressure, generally considered to be rare, can now be cured by surgery. And it may, he suggests, be a more common form than most doctors suspect.

From the Bark. Endocrinologist Conn got his lead from what seemed like experiments in a torture chamber. To help the armed forces cut down World War II manpower losses from tropical heat prostration, he kept volunteers working at 90DEG F. and a relative humidity of 80% to 90%. After about a week, the men became acclimated to the artificial weather.

But how? Dr. Conn reasoned that a hormone must be at work, influencing especially the body's handling of salts. But nobody had identified a hormone with such precise effects. He could only guess that it was one of the many produced by the outer cortex or "bark" of the adrenal glands which are astride the kidneys. In the early 1950s, other investigators confirmed Conn's hunch by isolating an adrenal hormone now called aldosterone and recognized as one of the most powerful of all the body's chemicals.

Into the Cure Column. First patient to get the benefit of Dr. Conn's aldosterone research was no tropic-bound G.I., but a 34-year-old Michigan woman whose high blood pressure (170 over 100) was accompanied by unusual features. She had muscular weakness and cramps, had to drink and urinate frequently; her low-salt sweat and abysmally low level of potassium in the blood indicated an excess of aldosterone. A medical team traced her trouble to a small tumor on her right adrenal gland, which was pumping out a flood of aldosterone although there was no excess of other adrenal hormones. Surgeons removed her tumor, and now, eight years later, the woman is well, with her blood pressure about normal.

''How many such patients there are." says Dr. Conn, "is anybody's guess." They run the gamut from those with strikingly severe symptoms to those detected only by chance chemical tests. And the picture is complicated because some victims of a rare, rapidly progressive and fatal form of high blood pressure develop an aldosterone excess apparently as an effect, rather than a cause, of their original disease. But whatever the statistics, the volunteers who pedaled themselves silly on Dr. Conn's exercise bicycles have a good deal to show for their sweat. At least 70% of aldosterone-tumor patients are being cured by surgery, and of the 25% listed only as improved, some are expected to move into the cured column when their convalescence is complete.

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