BACKGROUND: The aim of this study was to evaluate whether body mass index (BMI) is independently correlated with plasma aldosterone concentration (PAC) in treated essential hypertensive patients, and whether the relationship between BMI and high blood pressure (BP) can be partially mediated by PAC despite renin-angiotensin-aldosterone system blockade. METHODS: This study used a cross-sectional design and included 295 consecutive essential hypertensive patients referred to our centre for uncontrolled BP despite stable antihypertensive treatment for at least 6 months. The main exclusion criteria were age >65 years; glomerular filtration rate <30 ml/min; and therapy with mineralocorticoid receptor antagonists, direct renin inhibitors, amiloride or oral contraceptives. RESULTS: Higher levels of obesity showed a significantly higher mean PAC with a steep nonlinear increase in patients with BMI ≥ 35 kg/m(2). Class 2 and 3 obese patients had a higher mean PAC than nonobese and class 1 obese patients, even in patients under stable treatment with either angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). In a stepwise multiple linear regression model, only log of plasma renin activity (PRA), mean blood pressure (MBP), and class 2 and 3 obesity showed an independent correlation with PAC. In the same model applied to patients treated with ACEIs or ARBs, only logPRA and class 2 and 3 obesity showed a direct correlation with PAC. CONCLUSIONS: In treated essential hypertensive patients, a BMI ≥ 35 kg/m(2) is independently, albeit modestly, correlated with PAC. The correlation between BMI ≥ 35 kg/m(2) and PAC holds true even in ACEI/ARB-treated patients. Further study is required to determine whether the association of obesity with BP is mediated by PAC in hypertensive patients on stable therapy with ACEIs or ARBs.
BACKGROUND: The aim of this study was to evaluate whether body mass index (BMI) is independently correlated with plasma aldosterone concentration (PAC) in treated essential hypertensivepatients, and whether the relationship between BMI and high blood pressure (BP) can be partially mediated by PAC despite renin-angiotensin-aldosterone system blockade. METHODS: This study used a cross-sectional design and included 295 consecutive essential hypertensivepatients referred to our centre for uncontrolled BP despite stable antihypertensive treatment for at least 6 months. The main exclusion criteria were age >65 years; glomerular filtration rate <30 ml/min; and therapy with mineralocorticoid receptor antagonists, direct renin inhibitors, amiloride or oral contraceptives. RESULTS: Higher levels of obesity showed a significantly higher mean PAC with a steep nonlinear increase in patients with BMI ≥ 35 kg/m(2). Class 2 and 3 obesepatients had a higher mean PAC than nonobese and class 1 obesepatients, even in patients under stable treatment with either angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). In a stepwise multiple linear regression model, only log of plasma renin activity (PRA), mean blood pressure (MBP), and class 2 and 3 obesity showed an independent correlation with PAC. In the same model applied to patients treated with ACEIs or ARBs, only logPRA and class 2 and 3 obesity showed a direct correlation with PAC. CONCLUSIONS: In treated essential hypertensivepatients, a BMI ≥ 35 kg/m(2) is independently, albeit modestly, correlated with PAC. The correlation between BMI ≥ 35 kg/m(2) and PAC holds true even in ACEI/ARB-treated patients. Further study is required to determine whether the association of obesity with BP is mediated by PAC in hypertensivepatients on stable therapy with ACEIs or ARBs.
Authors: Alessia Buglioni; Valentina Cannone; Alessandro Cataliotti; S Jeson Sangaralingham; Denise M Heublein; Christopher G Scott; Kent R Bailey; Richard J Rodeheffer; Paolo Dessì-Fulgheri; Riccardo Sarzani; John C Burnett Journal: Hypertension Date: 2014-11-03 Impact factor: 10.190
Authors: Andrea Vecchiola; Carlos F Lagos; Cristian A Carvajal; Rene Baudrand; Carlos E Fardella Journal: Curr Hypertens Rep Date: 2016-03 Impact factor: 5.369
Authors: Wai Yan Sun; Bo Bai; Cuiting Luo; Kangmin Yang; Dahui Li; Donghai Wu; Michel Félétou; Nicole Villeneuve; Yang Zhou; Junwei Yang; Aimin Xu; Paul M Vanhoutte; Yu Wang Journal: JCI Insight Date: 2018-09-06
Authors: Amit Tirosh; Fady Hannah-Shmouni; Charalampos Lyssikatos; Elena Belyavskaya; Mihail Zilbermint; Smita B Abraham; Maya B Lodish; Constantine A Stratakis Journal: J Clin Hypertens (Greenwich) Date: 2017-06-13 Impact factor: 3.738