title: High plasma adrenomedullin concentrations in patients with high-renin essential hypertension.
abstract: Adrenomedullin (AM) is a novel peptide, first isolated from human phaeochromocytoma, which elicits a long-lasting vasorelaxant activity. Recently, it has been reported that endothelial cells produce AM and that immunoreactive AM plasma levels may be elevated in human arterial hypertension, although the exact pathophysiological role of AM remains to be established. The aim of our study was to determine the relationship between the components of the enin-angiotensin-aldosterone system (RAAS) and plasma AM levels in patients with low-, medium- or high- renin essential hypertension. The study groups included 10 patients with low-renin essential hypertension (average age 42+15 years), nine patients with medium-renin essential hypertension (46+13 years), 11 patients with high-renin essential hypertension (42+14 years) and 12 healthy subjects (43+11 years). Our results demonstrated that the mean AM values of all patients with essential hypertension were 10.85+3.14 pg/ml; there was a statistical correlation (r=0.705; p<0.001) between plasma renin activity (PRA) and AM levels in hypertensives. In patients with high-renin essential hypertension, plasma AM levels (14.2+2.2 pg/ml) were significantly higher (p<0.001) than those of healthy subjects (8.7+2.1 pg/ml), patients with medium-renin essential hypertension (8.5+1.4 pg/ml), and patients with low-renin essential hypertension (9.1+1.5 pg/ml). There was no statistical difference in AM concentrations between medium- and low-renin hypertensive patients. In conclusion, we have found that, in hypertensive patients, plasma AM levels were increased only in high-renin individuals, suggesting a role of AM in this particular form of human essential hypertension.
authors.affiliation: Department of Clinical Science, University of Rome La Sapienza, Italy. claudio.letizia@uniroma1.it
authors.forename: Claudio
authors.initials: C
authors.lastname: Letizia
authors.forename: Stefano
authors.initials: S
authors.lastname: Subioli
authors.forename: Sabrine
authors.initials: S
authors.lastname: Cerci
authors.forename: Chiara
authors.initials: C
authors.lastname: Caliumi
authors.forename: Cristiana
authors.initials: C
authors.lastname: Verrelli
authors.forename: Enrica
authors.initials: E
authors.lastname: Delfini
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Celi
authors.forename: Luigi
authors.initials: L
authors.lastname: Scuro
authors.forename: Emilio
authors.initials: E
authors.lastname: D' Erasmo
mesh_terms: D053607:Adrenomedullin; D000328:Adult; D000450:Aldosterone / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000097:blood*; D008875:Middle Aged; D010455:Peptides / Q000097:blood*; D012083:Renin / Q000097:blood*
chemical_list: D010455:Peptides; D053607:Adrenomedullin; D000450:Aldosterone; D012083:Renin