11beta-Hydroxysteroid dehydrogenase type 2 activity is associated with left ventricular mass in essential hypertension.
OBJECTIVE
Left ventricular mass (LVM) is under the control of aldosterone and angiotensin II in experimental hypertension, but the effect of aldosterone on LVM is controversial in essential hypertension (EH). Some EH patients show a mild impairment of 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) activity without clinical features of the syndrome of apparent mineralocorticoid excess, where the incomplete cortisol-to-cortisone conversion leads to glucocorticoid-mediated mineralocorticoid effects. The mineralocorticoid receptor and 11beta-HSD2 are co-expressed in human heart. We investigated whether LVM may be regulated by glucocorticoids in EH patients.


RESULTS
The ratio between 24 h urinary tetrahydro derivatives of cortisol and cortisone (THFs/THE), plasma renin activity, 24 h urinary aldosterone, blood pressure, and LVM indexed for height(2.7) (LVMh(2.7)) were analysed in 493 never-treated hypertensives and 98 normotensives. THFs/THE was associated with LVMh(2.7) in hypertensives and normotensives (r=0.32, P<0.001, and r=0.17, P=0.04, respectively) and persisted after adjusting for confounders (multiple regression analysis). Body mass index, sex, recumbent plasma renin activity, and THFs/THE accounted for 26.1% of LVMh(2.7) variation. Urinary aldosterone was not correlated with LVMh(2.7).


CONCLUSIONS
We suggest that glucocorticoids may take part in the regulation of LVM in EH patients as a function of 11beta-HSD2 activity, and contribute to the target organ damage associated with essential hypertension.
Glorioso
Nicola
N
Hypertension and Cardiovascular Prevention Centre, ASL n.1-University of Sassari, Italy. glorioso@uniss.it
Filigheddu
Fabiana
F
Parpaglia
Paolo Pinna
PP
Soro
Aldo
A
Troffa
Chiara
C
Argiolas
Giuseppe
G
Mulatero
Paolo
P
D043209:11-beta-Hydroxysteroid Dehydrogenase Type 2 / Q000378:metabolism*; D000450:Aldosterone / Q000652:urine; D001794:Blood Pressure / Q000502:physiology; D015331:Cohort Studies; D003350:Cortodoxone / Q000031:analogs & derivatives* / Q000652:urine; D004452:Echocardiography / Q000379:methods; D005260:Female; D005938:Glucocorticoids / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000201:enzymology* / Q000473:pathology / Q000652:urine; D017379:Hypertrophy, Left Ventricular / Q000201:enzymology* / Q000473:pathology / Q000652:urine; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000378:metabolism; D013760:Tetrahydrocortisol / Q000652:urine; D013761:Tetrahydrocortisone / Q000652:urine
D005938:Glucocorticoids; D000450:Aldosterone; D013761:Tetrahydrocortisone; C009412:tetrahydro-11-deoxycortisol; D013760:Tetrahydrocortisol; D043209:11-beta-Hydroxysteroid Dehydrogenase Type 2; D012083:Renin; D003350:Cortodoxone