Opposite associations of circulating aldosterone and atrial natriuretic peptide with left ventricular diastolic function in essential hypertension

Abstract

It has been shown in animal experiments that angiotensin II and aldosterone have mitogenic effects on the cardiovascular system, whereas atrial natriuretic peptide has antimitogenic properties. The aim of the present study was to relate plasma renin activity, angiotensin II, aldosterone and atrial natriuretic peptide to left ventricular structure and function, assessed by use of imaging echocardiography and transmitral Doppler velocimetry in 73 patients with essential hypertension, World Health Organization stages I-II, aged 43 ؎ 10 (s.d.) years. Left ventricular mass, wall thickness and internal diameter were not independently related to the biochemical variables, except for a weak and positive association of wall thickness with plasma aldosterone (P ‫؍‬ 0.06). However, left ventricular early inflow peak velocity and deceleration were independently and inversely related to age

Serum aldosterone effect on left ventricular structure and diastolic function in essential hypertension

“…These findings are consistent with previous research that found a positive relation between aldosterone levels and cardiac mass in patients with essential hypertension 14,28 . In other studies, however, no associations were detected between aldosterone levels and any variable of LV structure in essential hypertension patients 15,29 . These contradictory results could be due to the heterogeneity of the research participants evaluated, such as variances in dietary salt intake.…”

“… 14 , 28 In other studies, however, no associations were detected between aldosterone levels and any variable of LV structure in essential hypertension patients. 15 , 29 These contradictory results could be due to the heterogeneity of the research participants evaluated, such as variances in dietary salt intake. Human studies indicated that aldosterone requires a substantial dietary salt intake to manifest its adverse effect on the heart.…”

Serum aldosterone effect on left ventricular structure and diastolic function in essential hypertension

“…These findings are consistent with previous research that found a positive relation between aldosterone levels and cardiac mass in patients with essential hypertension 14,28 . In other studies, however, no associations were detected between aldosterone levels and any variable of LV structure in essential hypertension patients 15,29 . These contradictory results could be due to the heterogeneity of the research participants evaluated, such as variances in dietary salt intake.…”

“… 14 , 28 In other studies, however, no associations were detected between aldosterone levels and any variable of LV structure in essential hypertension patients. 15 , 29 These contradictory results could be due to the heterogeneity of the research participants evaluated, such as variances in dietary salt intake. Human studies indicated that aldosterone requires a substantial dietary salt intake to manifest its adverse effect on the heart.…”

Aldosterone Effect on Cardiac Structure and Function

“…For instance, one report enrolled 75 consecutive patients with never-treated essential hypertension and 45 normal controls, emphasizing the association between serum aldosterone and LVMI, RWT, and global longitudinal strain. In addition, aldosterone level was related to diastolic function, which is consistent with aldosterone's stimulating effect on myocardial fibrosis [ 29 , 30 ].…”

Antihypertensive Therapy: Role of Aldosterone Antagonists

“…A recent study [61] , beside confirming the "inappropriate" elevation of plasma aldosterone in relation to low plasma renin activity in hypertensive black Americans, found a direct correlation of plasma aldosterone levels with both blood pressure and cardiac mass in the subgroup of obese black American hypertensives. Moreover, Fagard and coworkers [62], evaluating the left ventricular morpho-functional characteristics of 73 essential hypertensive patients, found a significant association between high plasma aldosterone and impaired diastolic function, a result consistent with the animal experiments demonstrating the profibrotic action of aldosterone.…”

Serum aldosterone effect on left ventricular structure and diastolic function in essential hypertension

“…These findings are consistent with previous research that found a positive relation between aldosterone levels and cardiac mass in patients with essential hypertension 14,28 . In other studies, however, no associations were detected between aldosterone levels and any variable of LV structure in essential hypertension patients 15,29 . These contradictory results could be due to the heterogeneity of the research participants evaluated, such as variances in dietary salt intake.…”

“… 14 , 28 In other studies, however, no associations were detected between aldosterone levels and any variable of LV structure in essential hypertension patients. 15 , 29 These contradictory results could be due to the heterogeneity of the research participants evaluated, such as variances in dietary salt intake. Human studies indicated that aldosterone requires a substantial dietary salt intake to manifest its adverse effect on the heart.…”

Aldosterone Effect on Cardiac Structure and Function

“…For instance, one report enrolled 75 consecutive patients with never-treated essential hypertension and 45 normal controls, emphasizing the association between serum aldosterone and LVMI, RWT, and global longitudinal strain. In addition, aldosterone level was related to diastolic function, which is consistent with aldosterone's stimulating effect on myocardial fibrosis [ 29 , 30 ].…”

Antihypertensive Therapy: Role of Aldosterone Antagonists

“…A recent study [61] , beside confirming the "inappropriate" elevation of plasma aldosterone in relation to low plasma renin activity in hypertensive black Americans, found a direct correlation of plasma aldosterone levels with both blood pressure and cardiac mass in the subgroup of obese black American hypertensives. Moreover, Fagard and coworkers [62], evaluating the left ventricular morpho-functional characteristics of 73 essential hypertensive patients, found a significant association between high plasma aldosterone and impaired diastolic function, a result consistent with the animal experiments demonstrating the profibrotic action of aldosterone.…”

Serum aldosterone effect on left ventricular structure and diastolic function in essential hypertension

“…These findings are consistent with previous research that found a positive relation between aldosterone levels and cardiac mass in patients with essential hypertension 14,28 . In other studies, however, no associations were detected between aldosterone levels and any variable of LV structure in essential hypertension patients 15,29 . These contradictory results could be due to the heterogeneity of the research participants evaluated, such as variances in dietary salt intake.…”

“… 14 , 28 In other studies, however, no associations were detected between aldosterone levels and any variable of LV structure in essential hypertension patients. 15 , 29 These contradictory results could be due to the heterogeneity of the research participants evaluated, such as variances in dietary salt intake. Human studies indicated that aldosterone requires a substantial dietary salt intake to manifest its adverse effect on the heart.…”

Aldosterone Effect on Cardiac Structure and Function

“…For instance, one report enrolled 75 consecutive patients with never-treated essential hypertension and 45 normal controls, emphasizing the association between serum aldosterone and LVMI, RWT, and global longitudinal strain. In addition, aldosterone level was related to diastolic function, which is consistent with aldosterone's stimulating effect on myocardial fibrosis [ 29 , 30 ].…”

Antihypertensive Therapy: Role of Aldosterone Antagonists

“…A recent study [61] , beside confirming the "inappropriate" elevation of plasma aldosterone in relation to low plasma renin activity in hypertensive black Americans, found a direct correlation of plasma aldosterone levels with both blood pressure and cardiac mass in the subgroup of obese black American hypertensives. Moreover, Fagard and coworkers [62], evaluating the left ventricular morpho-functional characteristics of 73 essential hypertensive patients, found a significant association between high plasma aldosterone and impaired diastolic function, a result consistent with the animal experiments demonstrating the profibrotic action of aldosterone.…”