Comparisons of skin microvascular changes in patients with primary aldosteronism and essential hypertension

Concistrè, Antonio; Petramala, Luigi; Bonvicini, Maria; Gigante, Antonietta; Collalti, Giulia; Pellicano, Chiara; Olmati, Federica; Iannucci, Gino; Soldini, Maurizio; Rosato, Edoardo; Letizia, Claudio

doi:10.1038/s41440-020-0475-4

Cited by 8 publications

(2 citation statements)

References 36 publications

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“…Dysregulation of excess aldosterone is well known to cause patients to be at high risk of refractory hypertension, severe hypokalemia or related cardiovascular morbidity and mortality ( 21 ). A recent study reveals that aldosterone may have a pathophysiological role in microvascular remodeling in patients with PA ( 22 ). Accumulating evidence suggests that aldosterone plays important role in the initiation and progression of endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Clinical impacts of endothelium-dependent flow-mediated vasodilation assessment on primary aldosteronism

Watanabe

Morimoto

Morishima

et al. 2021

Endocrine Connections

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Objective: Primary aldosteronism (PA) is divided into two major subtypes, aldosterone-producing adenoma (APA) and bilateral idiopathic hyperplasia (IHA), and is associated with a higher risk of cardiovascular events. However, the nature of vascular function in PA patients remains to be determined. The aim of this study was to determine vascular function and investigate the implications of vascular function assessments in these patients. Methods: Flow-mediated dilation (FMD), as an index of endothelial function, and cardio-ankle vascular index (CAVI), as an index of arterial stiffness, were retrospectively compared between 42 patients with APA, 37 patients with IHA, and 42 patients with essential hypertension (EH). These values were also compared with background factors, KCNJ5 mutation and clinical outcome in terms of blood pressure reduction after adrenalectomy in the APA group. Results: FMD was significantly lower in the APA group (4.8±2.1%) and IHA group (4.1±1.9%) than in the EH group (5.7±2.1%). CAVI did not differ significantly among groups. Although no significant correlations were seen between FMD and background factors in the IHA group, FMD correlated negatively with body mass index and plasma aldosterone concentration in the APA group (rs=-0.313, rs=-0.342, respectively). KCNJ5 mutational status was not associated with FMD value. High FMD was associated with blood pressure normalization after adrenalectomy in the APA group. Conclusions: Patients with PA displayed impaired endothelial function. Complete clinical success after adrenalectomy was associated with preserved endothelial function. This study provides a better understanding of FMD assessment in patients with PA.

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Section: Discussionmentioning

confidence: 99%

Clinical impacts of endothelium-dependent flow-mediated vasodilation assessment on primary aldosteronism

Watanabe

Morimoto

Morishima

et al. 2021

Endocrine Connections

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“…These skin samples also showed a higher expression of MR, the glucocorticoid receptor (GR), and 11β-hydroxysteroid dehydrogenase type 2 (HSD11β2) [ 9 ]. In addition, altered skin perfusion, negatively correlated with ALDO plasma levels, and greater cutaneous microvascular dysfunction, were observed in patients with PA, compared with patients with essential hypertension [ 10 ]. Thus, based on these findings, it could be suggested that ALDO plays a pathophysiological role in skin microcirculation.…”

Section: Introductionmentioning

confidence: 99%

Aldosterone Increases Vascular Permeability in Rat Skin

Aleksiejczuk

Gromotowicz-Popławska

Marcińczyk

et al. 2022

Cells

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The aim of this study was to evaluate the effect of acute aldosterone (ALDO) administration on the vascular permeability of skin. ALDO was injected intradermally into rats, and vascular permeability was measured. Eplerenone (EPL), a selective mineralocorticoid receptor (MR) antagonist, was used. Skin biopsies were carried out for immunohistochemical (IHC) staining, and polymerase chain reactions were performed to analyze the expression of MR, 11β-hydroxysteroid dehydrogenase type 2, von Willebrand factor (vWF), vascular endothelial growth factor (VEGF), and zonula occludens 1. Our study showed the presence of MR in the rat skin vasculature for the first time. It was found that ALDO injection resulted in a more than 30% increase in vascular permeability and enhanced the endothelial exocytosis of vWF. The effect of ALDO diminished after EPL administration. An accumulation of vWF and a reduction in VEGF IHC staining were observed following chronic EPL administration. No effect of ALDO or EPL on the mRNA expression of the studied genes or skin structure was observed. The results suggest that ALDO increases vascular permeability in the skin via an MR-dependent mechanism. This effect of ALDO on skin microcirculation may have important therapeutic implications for diseases characterized by increased levels of ALDO and coexisting skin microangiopathy.

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Overview of Peripheral Arterial Disease of the Lower Extremity

AbuRahma

Campbell

2021

Noninvasive Vascular Diagnosis

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Comparisons of skin microvascular changes in patients with primary aldosteronism and essential hypertension

Cited by 8 publications

References 36 publications

Clinical impacts of endothelium-dependent flow-mediated vasodilation assessment on primary aldosteronism

Clinical impacts of endothelium-dependent flow-mediated vasodilation assessment on primary aldosteronism

Aldosterone Increases Vascular Permeability in Rat Skin

Overview of Peripheral Arterial Disease of the Lower Extremity

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