High-circulating leptin levels are associated with increased blood pressure in uncontrolled resistant hypertension

Abstract

Leptin and aldosterone have been associated with the pathophysiological mechanisms of hypertension. However, despite studies showing the association of leptin with intima-media thickness, arterial distensibility and sympathetic nerve activation, the relationship between leptin and blood pressure (BP) in resistant hypertension (RHTN) is unknown. We aimed to assess the correlation of plasma leptin and aldosterone levels with BP in uncontrolled controlled RHTN (UCRHTN) and CRHTN patients. Plasma leptin and aldosterone levels, office BP, ambulatory BP monitoring and heart rate were measured in 41 UCRHTN, 39 CRHTN and 31 well-controlled HTN patients. No differences were observed between the three groups regarding gender, body mass index and age. The UCRHTN group had increased leptin when compared with CRHTN and well-controlled HTN patients (38.2±21.4, 19.6±8.7 and 20.94±13.9 ng ml(-1), respectively; P<0.05). Aldosterone levels values were also statistically different when comparing RHTN, CRHTN and well-controlled HTN patients (9.6±3.8, 8.1±5.0 and 8.0±4.7 ng dl(-1), respectively; P<0.05). As expected, UCRHTN patients had higher heart rate values compared with CRHTN and well-controlled HTN patients (86.2±7.2, 83.5±6.7 and 83.4±8.5, respectively; P<0.05). Plasma leptin positively correlated with systolic (SBP) and diastolic BP (DBP), and aldosterone (r=0.43, 0.35 and 0.47, respectively; all P<0.05) in UCRHTN, but neither in the CRHTN nor in the HTN group. Simple linear regression showed that SBP, DBP and aldosterone may be predicted by leptin (r(2)=0.16, 0.15 and 0.19, respectively; all P<0.05) only in the UCRHTN subgroup. In conclusion, UCRHTN patients have higher circulating leptin levels associated with increased plasma aldosterone and BP levels when compared with CRHTN and HTN subjects.

An update on the role of adipokines in arterial stiffness and hypertension

“…Even though some controversies have been found in the literature, imbalanced adipokines levels have been related to hypertension [11][12][13], as well as in vascular manifestations [3,7,14]. Even though some controversies have been found in the literature, imbalanced adipokines levels have been related to hypertension [11][12][13], as well as in vascular manifestations [3,7,14].…”

“…Also, arterial stiffness is a frequent vascular complication in hypertensive patients and represents an increased cardiovascular risk [10]. Imbalanced levels of adipokines have been associated with hypertension and BP control [11][12][13], as well as vascular manifestations of the condition [3,7,14]. In this review, we summarize the findings on the implications of the most studied adipokines: adiponectin, leptin and resistin, in arterial stiffness and hypertension.…”

Adipocyte-Derived Hormone Leptin Is a Direct Regulator of Aldosterone Secretion, Which Promotes Endothelial Dysfunction and Cardiac Fibrosis

“…Several investigators have reported the existence of as-yet-unidentified macromolecular stimuli of aldosterone synthesis released from cultured human adipocytes, [10][11][12] whereas a positive correlation between aldosterone and the adipocyte-derived hormone leptin has recently been established. 13 Based on these data, we hypothesized that the adipocyte-derived hormone leptin directly regulates aldosterone synthase (CYP11B2) expression and aldosterone production in adrenal zona glomerulosa cells and promotes cardiovascular dysfunction via aldosterone-dependent mechanisms.…”

Plasma Leptin Concentration and Sympathetic Nervous Activity in Older Adults With Physical Dysfunction

“…Plasma leptin has shown a positive relationship with blood pressure by simple correlation in previous reports. However, in multiple regression models, the relationship has shown contradictory results [16–19]. Aging and fat mass affect both plasma leptin and blood pressure; however, the importance of the relationship is thought to diminish after adjusting for covariates [18].…”

“…A high plasma leptin concentration is also known to elevate the blood pressure [16–19]. However, older adults with frailty who were considered to have high plasma leptin levels were also reported to have low blood pressure and high mortality [20–23].…”