Serum Aldosterone Levels in Hypertension
DOI:
https://doi.org/10.3823/2079Keywords:
Aldosterone, resistant hypertension, arterial hypertensionAbstract
Aims:Â Hypertension affects around 30% of the adult population. It is related to cardiovascular complications, especially on account of atherosclerosis. Resistant hypertension (RH) occurs when blood pressure remains above target value despite the use of three antihypertensive medications with synergistic actions at maximum recommended doses or whenever the patient makes use of four or more antihypertensive drugs even when blood pressure is controlled. Hyperaldosteronism is an important cause of RH. The study aims to evaluate the association of aldosterone concentrations not only in essential hypertensive individuals but with RH correlating also with inflammatory levels. Methods: A total of 44 EH patients and 32 RH patients were selected. All of them were submitted to serum analysis of urea, creatinine, potassium, aldosterone, fasting glycemia, glycated hemoglobin (HbA1C), complete blood count, usCRP, homocysteine and beta-2 microglobulin (B2M). Results: No significant difference could be observed among the groups regarding the inflammatory markers TNF-alpha, IL-6, usCRP, homocysteine and B2M. As to aldosterone and the ratio of albumin to creatinine (ACR), there was an expressive difference; however, no correlation between ACR and aldosterone could be found.Conclusions: Â In this sample of hypertensive individuals, aldosterone levels are relatively higher in RH when compared with those with EH.
References
Alessi A, Brandão AA, Coca A, Cordeiro AC, Nogueira Ar, Diógenes de Magalhães F, Amodeo C, Saad Rodrigues CI, Calhoun DA, Barbosa Coelho E, Pimenta E, et al. First Brazilian Position on Resistant Hypertension. Arq Bras Cardiol 2013; 100(3): 304.
Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, White A, Cushman WC, White W, Sica D, Ferdinand K, Giles TD, Falkner B, Carey RM; Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension. 2008;51(6):1403-19.
Girioli, SU. Hipertensão arterial resistente: Papel da aldosterona e o efeito de seu antagonista espironolactona no remodelamento cardiovascular e função endotelial / Samira Ubaid Girioli. Campinas, SP : [s.n.], 2009.
Real de Asúa D, Purchades R, Garcia-Poli I, Suarez C. Beta 2- Microglobulin in High-Vascular- Risk Patientes. Int Cardiovascular Res J. 2012;6(4).
Baszczuk A, Musialik K, Kopczynski J, Thielemann A, Kopczynski Z, Kesy L, Dopierala G. Hyperhomocysteinemia, Lipid and Lipoprotein Disturbances in Patients with Primary Hypertencsion. Advances in Medical Sciences 59 (2014) 68-73.
Oliveira-Filho AF, Barreto-Filho JA, Neves SJF, Lyra DPJr. Association between the 8-item Morisky Medication Adherence Scale (MMAS-8) and Blood Pressure Control. Bras Cardiol. 2012; 99(1) 649-658
Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130(6):461–470
Peterson PA, Cunningham BA, Berggard I, Edelman GM. Beta 2- macroglobulin- a free immunoglobulin domais. Proc Natl Acad Sci USA 1972; 69: 1697-701.
Li JJ, Li Q, Du HP, You SJ, Wang Fe, Xu XS, Cheng J, Cao YJ, Liu C, Hu LF. Homocysteine Triggers Inflammatory Responses in Macrophages Through Inhibiting CSE-H2S Signaling via DNA Hypermethylation of CSE Promoter. Int. J. Mol. Sci. 2015, 16, 12560-12577.
Gutiérrez OM, Khodneva YA, Muntner P, Rizk DV, McClellan WM, Cushman M, Warnock DG and Safford MM. Association between urinary albumin excretion and coronary heart disease in black versus white adults. JAMA. 2013 Aug 21; 310 (7):10.1001
Rigolo MJ, Bacci MR, Murad N, Chagas ACP, Alves BCA, Fonseca FLA. Serum Aldosterone Levels in Hemodialysis Patients: A Systematic Review. Int. Arch. of Medicine. 2015; Vol 8 No.31.
Sacks FM, Campos H. Dietary therapy in hypertension. N Engl J Med. 2012: 362(22):2012-12.
Krum H, Schlaich M, Whitbourn R, Sobotka PA, Sadowski J, Bartus K, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicenter safety and proof-of-principle cohort study. Lancet. 2009;373(9671):1275-81.
Esler MD, Krum H, Schlaich M, Schmieder RE, Bohm M, Sobotka PA, et al. Renal sympathetic denervation for treatment of drug-resistant hypertension: one year results from the Simplicity HTN-2 randomized, controlled trial. Circulation. 2012:126(25):2976-82.
Schumacher CD, Steele RE, Brunner HR. Aldosterone synthase inhibition for the treatment of hypertension and the derived mechanistic requirements dor a new therapeutic strategy.
Prevention and Treatment if Hypertension With Algorithm-based therapy (PATHWAY) number 2: protocol for a randomized crossover trial to determine optimal treatment for drug-resistant hypertension.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access and Benefits of Publishing Open Access).
Â
Â