Influence of arterial blood pressure and aldosterone on left ventricular hypertrophy in moderate essential hypertension

Duprez, Daniel; Bauwens, Frank; Buyzere, Marc L. De; Backer, Tine L. De; Kaufman, Jean M.; Hoecke, José Van; Vermeulen, A.; Clément, Denis

doi:10.1016/0002-9149(93)90240-d

Cited by 124 publications

(73 citation statements)

References 22 publications

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“…11 Other studies, primarily in white subjects, have found little or no association of aldosterone with blood pressure levels or with hypertension. [12][13][14] However, in a community-based sample, increased serum aldosterone concentrations within the physiological range predisposed persons to the subsequent development of hypertension. 15 Several reports describe an association of aldosterone with body mass index (BMI) and anthropometric measures of centripetal obesity.…”

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confidence: 98%

Association of Adrenal Steroids With Hypertension and the Metabolic Syndrome in Blacks

et al. 2007

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Abstract-Blacks have a high prevalence of hypertension and adrenal cortical adenomas/hyperplasia. We evaluated the hypothesis that adrenal steroids are associated with hypertension and the metabolic syndrome in blacks. Ambulatory blood pressures, anthropometric measurements, and measurements of plasma renin activity (PRA), aldosterone, fasting lipids, glucose, and insulin were obtained in 397 subjects (46% hypertensive and 50% female) after discontinuing antihypertensive and lipid-lowering medications. Hypertension was defined as average ambulatory blood pressure Ͼ130/85 mm Hg. Late-night and early morning salivary cortisol, 24-hour urine-free cortisol, and cortisone excretion were measured in a consecutive subsample of 97 subjects (40% hypertensive and 52% female). Compared with normotensive subjects, hypertensive subjects had greater waist circumference and unfavorable lipid profiles, were more insulin resistant, and had lower PRA and higher plasma aldosterone and both late-night and early morning salivary cortisol concentrations. Twenty-four-hour urine-free cortisol and cortisone did not differ. Overall, ambulatory blood pressure was positively correlated with plasma aldosterone (rϭ0.22; PϽ0.0001) and late-night salivary cortisol (rϭ0.23; Pϭ0.03) and inversely correlated with PRA (rϭϪ0.21; PϽ0.001). Plasma aldosterone correlated significantly with waist circumference, total cholesterol, triglycerides, insulin, and the insulin-resistance index. Based on Adult Treatment Panel III criteria, 17% of all of the subjects were classified as having the metabolic syndrome. Plasma aldosterone levels, but not PRA, were elevated in subjects with the metabolic syndrome (Pϭ0.0002). The association of aldosterone with blood pressure, waist circumference, and insulin resistance suggests that aldosterone may contribute to obesity-related hypertension in blacks. In addition, we speculate that relatively high aldosterone and low PRA in these hypertensive individuals may reflect a mild variant of primary aldosteronism. Key Words: aldosterone Ⅲ cortisol Ⅲ hypertension Ⅲ metabolic syndrome Ⅲ insulin resistance Ⅲ plasma renin activity T he prevalence of hypertension in African-Americans is among the highest in the world. In the United States, compared with whites, hypertension is 50% more frequent in blacks. 1,2 Blacks develop hypertension at a young age and have higher rates of hypertension-related deaths and cardiovascular complications including stroke, heart disease, and end-stage renal disease. 2 In both black and white populations, hypertension is frequently associated with centripetal obesity, insulin resistance, and dyslipidemia. [3][4][5] This constellation of risk factors has been termed the metabolic syndrome and is associated with increased cardiovascular disease morbidity and mortality. 6,7 Based on an earlier study of the records of 35 000 consecutive autopsies, an increased prevalence of adrenal cortical adenomas and hyperplasia has been observed in association with essential hypertension, particularly in younger and ...

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confidence: 98%

Association of Adrenal Steroids With Hypertension and the Metabolic Syndrome in Blacks

et al. 2007

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“…19 However, a number of studies, primarily in white subjects, have not found an elevation of aldosterone in hypertension, 6,20,21 and recent reports indicate either no correlation or weakly positive correlations between plasma aldosterone and blood pressure in white patients with essential hypertension. 22,23 Most of these studies were based on isolated blood pressure measurements and did not use careful control of time, diet, and posture. Further suggesting a role for aldosterone in the pathogenesis of hypertension, addition of low-dose spironolactone to the antihypertensive regimen has been reported to provide significant additive blood pressure reduction in black and white subjects with resistant hypertension, whether or not they have primary aldosteronism.…”

Section: Grim Et Al Aldosterone and Hypertension 769mentioning

confidence: 99%

Hyperaldosteronism and Hypertension

et al. 2005

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Abstract-The purpose of this study is to evaluate the relationship between aldosterone and blood pressure in a total of 220 normotensive and 293 essential hypertensive subjects in 2 genetically distinct populations-blacks and white French Canadians. The 24-hour blood pressure monitoring was performed under standardized conditions after discontinuing antihypertensive medications. Plasma renin activity and plasma aldosterone were measured in the supine position and after standing for 10 minutes. Plasma atrial natriuretic factor was also measured. Supine and standing plasma renin activities were lower (PՅ0.01), plasma aldosterone was higher (PϽ0.0001), and the aldosterone/renin ratios were higher (PϽ0.0001) in the hypertensive subjects. Atrial natriuretic factor was also higher in the hypertensive subjects (PϽ0.0001). Among blacks, blood pressures did not correlate with plasma renin activity. However, both average daytime and nighttime systolic and diastolic blood pressures were correlated with supine and standing plasma aldosterone and with the aldosterone/renin ratio (PϽ0.005 or less). In French Canadians, blood pressures tended to be positively correlated with standing plasma renin activity and aldosterone, but not with the aldosterone/renin ratio.Correlations of blood pressure with aldosterone were more consistent and more striking in blacks than in French Canadians. In both ethnic groups, there were inconsistent correlations of blood pressure with atrial natriuretic factor. These observations are consistent with the hypothesis that aldosterone-induced volume expansion is an important contributor to hypertension, especially in blacks.

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“…It was reported that LVH has a greater impact on survival in women than in men both in the patients with and without coronary artery disease (16,17 (18)(19)(20)(21)(22)(23)(24). The two major factors in the pathogenesis of LVH postulated on the basis of experimental results are hemodynamic and non-hemodynamic factors (24).…”

Section: T a B L E 6 S T E P Wi S E Mu L T I P L E Re G R E S S I Omentioning

confidence: 99%

Gender-related Differences in Target Organ Damage in Untreated Patients with Essential Hypertension

et al. 2006

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Influence of arterial blood pressure and aldosterone on left ventricular hypertrophy in moderate essential hypertension

Cited by 124 publications

References 22 publications

Association of Adrenal Steroids With Hypertension and the Metabolic Syndrome in Blacks

Association of Adrenal Steroids With Hypertension and the Metabolic Syndrome in Blacks

Hyperaldosteronism and Hypertension

Gender-related Differences in Target Organ Damage in Untreated Patients with Essential Hypertension

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