Valentina Cannone1, Alessia Buglioni2, S Jeson Sangaralingham2, Christopher Scott3, Kent R Bailey3, Richard Rodeheffer4, Margaret M Redfield5, Riccardo Sarzani6, John C Burnett2. 1. Cardiorenal Research Laboratory, Division of Circulatory Failure, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN; Division of Clinical Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy. Electronic address: cannone.valentina@mayo.edu. 2. Cardiorenal Research Laboratory, Division of Circulatory Failure, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN. 3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN. 4. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN. 5. Cardiorenal Research Laboratory, Division of Circulatory Failure, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN. 6. Internal Medicine and Geriatrics and "Hypertension Excellence Centre" of the European Society of Hypertension, Department of Clinical and Molecular Sciences, University "Politecnica delle Marche", Ancona, Italy; Italian National Research Centre on Aging "U. Sestilli", IRCCS-INRCA, Ancona, Italy.
Abstract
OBJECTIVE: To investigate the relationships among aldosterone level, use of antihypertensive (anti-HTN) medications, clinical profile, and atrial natriuretic peptide (ANP) level in individuals with HTN. PARTICIPANTS AND METHODS: In a community-based cohort, we analyzed aldosterone plasma levels based on the presence (n=477) or absence (n=1073) of HTN. In individuals with HTN, we evaluated circulating aldosterone levels according to the number of anti-HTN drugs used, analyzed the associated clinical characteristics, and determined the relationship to the counterregulatory cardiac hormone ANP. Data were collected from August 25, 1997, through September 5, 2000. RESULTS: Participants with HTN had higher serum aldosterone levels than those without HTN (6.4 vs 4.1 ng/dL [to convert to pmol/L, multiply by 27.74]; P<.001). When individuals with HTN were stratified according to the number of anti-HTN medications used, the increase in number of medications (0, 1, 2, and ≥3) was associated with higher aldosterone levels (4.8, 6.4, 7.10, and 7.9 ng/dL, respectively; P=.002), worse metabolic profile, and higher prevalence of cardiovascular, renal, and metabolic disease. In participants with HTN, ANP plasma levels were inversely related to aldosterone levels when the latter was divided into tertiles. CONCLUSION: In this randomly selected general population cohort, aldosterone levels were higher in individuals with HTN compared with normotensive participants. Aldosterone levels increased with anti-HTN medication use. These findings also suggest a relative ANP deficiency with increasing aldosterone levels and anti-HTN drug use. These studies have pathophysiologic and therapeutic implications for targeting aldosterone in the clinical treatment of HTN.
OBJECTIVE: To investigate the relationships among aldosterone level, use of antihypertensive (anti-HTN) medications, clinical profile, and atrial natriuretic peptide (ANP) level in individuals with HTN. PARTICIPANTS AND METHODS: In a community-based cohort, we analyzed aldosterone plasma levels based on the presence (n=477) or absence (n=1073) of HTN. In individuals with HTN, we evaluated circulating aldosterone levels according to the number of anti-HTN drugs used, analyzed the associated clinical characteristics, and determined the relationship to the counterregulatory cardiac hormone ANP. Data were collected from August 25, 1997, through September 5, 2000. RESULTS: Participants with HTN had higher serum aldosterone levels than those without HTN (6.4 vs 4.1 ng/dL [to convert to pmol/L, multiply by 27.74]; P<.001). When individuals with HTN were stratified according to the number of anti-HTN medications used, the increase in number of medications (0, 1, 2, and ≥3) was associated with higher aldosterone levels (4.8, 6.4, 7.10, and 7.9 ng/dL, respectively; P=.002), worse metabolic profile, and higher prevalence of cardiovascular, renal, and metabolic disease. In participants with HTN, ANP plasma levels were inversely related to aldosterone levels when the latter was divided into tertiles. CONCLUSION: In this randomly selected general population cohort, aldosterone levels were higher in individuals with HTN compared with normotensive participants. Aldosterone levels increased with anti-HTN medication use. These findings also suggest a relative ANP deficiency with increasing aldosterone levels and anti-HTN drug use. These studies have pathophysiologic and therapeutic implications for targeting aldosterone in the clinical treatment of HTN.
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: Luis Miguel Ruilope; Andrej Dukat; Michael Böhm; Yves Lacourcière; Jianjian Gong; Martin P Lefkowitz Journal: Lancet Date: 2010-03-16 Impact factor: 79.321
Authors: Deepak K Gupta; Lori B Daniels; Susan Cheng; Christopher R deFilippi; Michael H Criqui; Alan S Maisel; Joao A Lima; Hossein Bahrami; Philip Greenland; Mary Cushman; Russell Tracy; David Siscovick; Alain G Bertoni; Valentina Cannone; John C Burnett; John Jeffrey Carr; Thomas J Wang Journal: Am J Cardiol Date: 2017-06-30 Impact factor: 2.778
Authors: Bryan Williams; Thomas M MacDonald; Steve Morant; David J Webb; Peter Sever; Gordon McInnes; Ian Ford; J Kennedy Cruickshank; Mark J Caulfield; Jackie Salsbury; Isla Mackenzie; Sandosh Padmanabhan; Morris J Brown Journal: Lancet Date: 2015-09-20 Impact factor: 79.321
Authors: Solomon K Musani; Ramachandran S Vasan; Aurelian Bidulescu; Jiankang Liu; Vanessa Xanthakis; Mario Sims; Ravi K Gawalapu; Tandaw E Samdarshi; Michael Steffes; Herman A Taylor; Ervin R Fox Journal: Diabetes Care Date: 2013-06-11 Impact factor: 19.112
Authors: Katie A Meyer; Lisa J Harnack; Russell V Luepker; Xia Zhou; David R Jacobs; Lyn M Steffen Journal: J Am Heart Assoc Date: 2013-10-02 Impact factor: 5.501
Authors: Laura M G Meems; Ingrid A Andersen; Shuchong Pan; Gail Harty; Yang Chen; Ye Zheng; Gerald E Harders; Tomoki Ichiki; Denise M Heublein; Seethalakshmi R Iyer; S Jeson Sangaralingham; Daniel J McCormick; John C Burnett Journal: Hypertension Date: 2019-04 Impact factor: 9.897