Genetic studies of cation tests and hypertension.

Williams, Roger R.; Hasstedt, Sandra J.; Hunt, Steven C.; Wu, Lily; Ash, K O

doi:10.1161/01.hyp.10.5_pt_2.i37

Cited by 9 publications

(1 citation statement)

References 29 publications

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“…We have to emphasize, however, that sodium-proton exchange and SLC do not necessarily reflect the same phenotype or genotype 21 and that SLC is, between these, the most studied transport system in epidemiological investigations on predictors of hypertension. 30,36,37 On the other hand, in agreement with our results, Falkner et al 38 have demonstrated a relationship between UAE rate and SLC in young adult African Americans with borderline to mild hypertension.…”

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confidence: 93%

Insulin, Sodium-Lithium Countertransport, and Microalbuminuria in Hypertensive Patients

et al. 1998

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Both microalbuminuria (0.290 nmol/min [20 g/min]) and high sodium-lithium countertransport (SLC) in diabetic or hypertensive humans are predictive of overt nephropathy and more aggressive cardiovascular complications, perhaps induced by insulin resistance. To analyze the relationships between microalbuminuria, SLC, microalbuminuria, and insulin in essential hypertension, we studied 90 hypertensive white patients, 25 of whom had microalbuminuria and 32 of whom were healthy. When urine sampling was completed for albuminuria determination, SLC was measured; all patients then underwent standard (75 g) oral glucose load to measure basal (0 minutes) and 2-hour glucose and insulin serum levels. Glucose-insulin ratio was used as insulin sensitivity index (ISI). In both hypertensive patients with normal microalbuminuria and those with pathological microalbuminuria, plasma insulin at 120 minutes was significantly higher than in control subjects. When the patients with pathological microalbuminuria were divided into thirds on the basis of their microalbuminuria, in the lower third, we found statistically significant less fasting insulin and higher basal ISI. SLC was higher in hypertensives than normotensives and, among hypertensives, higher in the subgroup with elevated microalbuminuria. In hypertensives, we found a weak but significant correlation between SLC and microalbuminuria, independent of insulin or ISI. The prevalence of high value of SLC (0.383 mmol L 1 h 1) was significantly lower in hypertensives with normal rather than abnormal urinary albumin excretion. Our results indicate that in nondiabetic hypertensive whites, higher microalbuminuria is accompanied by signs of insulin resistance; moreover, a link exists between SLC and microalbuminuria, both predictive of aggressive complications of hypertension. (Hypertension. 1998;31[part 1]:110-113.) Key Words: insulin sodium-lithium countertransport microalbuminuria insulin resistance cardiovascular risk nephropathy M icroalbuminuria, defined as urinary albumin excretion (UAE) rate 0.290 nmol/min (20 g/min), has recently been recognized in diabetes mellitus predictive of overt ne-phropathy and more aggressive cardiovascular complications. 1-3 It has also been related to 24-hour blood pressure levels in hypertensive nondiabetic subjects 4,5 and regarded as an independent risk factor for renal and cardiovascular damage. 4,6 Increased sodium-lithium countertransport (SLC) activity is another marker of renal and cardiovascular complications in diabetes 7,8 and in essential hypertension, 9,10 where it could be linked to an insulin-resistance condition. 11-13 The aim of this study is to analyze the relationships between microalbumin-uria, SLC, and insulin in essential nondiabetic hypertensive whites. Methods We studied 90 white patients with mild to moderate essential hypertension lasting no more than 5 years and 32 healthy subjects from laboratory and ward staff with comparable body mass index, race, and gender distribution (Table 1). All gave their informed consent, and t...

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confidence: 93%

Insulin, Sodium-Lithium Countertransport, and Microalbuminuria in Hypertensive Patients

et al. 1998

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Familial aggregation of cardiovascular diseases in African‐American pedigrees

Rotimi

Cooper

Cao

et al. 1994

Genetic Epidemiology

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Familial aggregation of cardiovascular diseases and diabetes has been consistently demonstrated. However, virtually all of the evidence on the familial patterns of these diseases has come from white population samples. This study evaluates the level of familial excess risk among first degree relatives of 232 African-American pedigrees which included 1,420 individuals recruited from the Chicago, IL, area. Excess disease risk was observed among relatives (parents and offsprings) of affected probands compared to relatives of unaffected probands for coronary heart disease (odds ratio [OR] = 5.30; 95% confidence interval [CI] = 2.51-11.23); hypertension (OR = 1.98; CI = 1.41-2.80); stroke (OR = 3.24; CI = 1.08-9.70); and diabetes (OR = 2.95; CI = 1.55-5.62). The results of this study clearly show that coronary heart disease, hypertension, stroke, and diabetes aggregate in some African-American families and not others. Unaffected relatives of persons suffering from these diseases should be encouraged to have their blood pressure, lipid, and blood glucose levels measured at frequent intervals. These recommendations are particularly urgent in African-American communities because of the disproportionately high morbidity and mortality experienced from cardiovascular diseases and diabetes.

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