Acute eprosartan-induced intrarenal vasodilation in hypertensive humans is not influenced by dietary sodium intake or angiotensin II co-infusion

Background: Angiotensin II (Ang II) is thought to play an important role in the development of hypertension. Nevertheless, knowledge on the angiotensin II type-1-receptors (AT(1)Rs) in the hypertensive kidney and the influence of sodium intake and renin-angiotensin system activity on intrarenal AT(1)R blockade is scarce. To improve our understanding of renal AT(1)Rs in hypertensive patients, we studied the effects of acute, local administration of AT(1)R-blocker eprosartan in kidneys of patients with essential hypertension (off medication). Method: In 73 hypertensive patients who were scheduled for diagnostic renal angiography, we measured renal blood flow (133 Xenon washout method) before and during intrarenal infusion of two incremental doses of eprosartan (3 and 10 mg/kg/min for 15 min per dose). We hypothesized that the vasodilatory effects of eprosartan would be enhanced by low sodium intake and would be reduced during Ang II co-infusion. Therefore, we allocated the patients to either a high or a low sodium diet and coinfused Ang II (1 ng/kg/min) in a subgroup. Results: Eprosartan infusion resulted in intrarenal vasodilation in all groups. No differences in the magnitude of this effect were found between the groups. No correlation was found between 24-h urinary sodium excretion (a proxy for dietary sodium intake) and the effect of eprosartan. Conclusion: Eprosartan-induced vasodilation is not influenced by sodium intake and/or co-infusion of Ang II. These rather unexpected findings could be explained by differences between circulating and tissue Ang II levels, variations in AT(1)R expression, and/or stimulation of other vasodilatory pathways.