• Mayo Clinic proceedings · Aug 2018

    Comparative Study

    Aldosterone, Hypertension, and Antihypertensive Therapy: Insights From a General Population.

    • Valentina Cannone, Alessia Buglioni, S Jeson Sangaralingham, Christopher Scott, Kent R Bailey, Richard Rodeheffer, Margaret M Redfield, Riccardo Sarzani, and John C Burnett.
    • 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.
    • Mayo Clin. Proc. 2018 Aug 1; 93 (8): 980990980-990.

    ObjectiveTo 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 MethodsIn 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.ResultsParticipants 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.ConclusionIn 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.Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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