title: 11beta-Hydroxysteroid dehydrogenase type 2 activity is associated with left ventricular mass in essential hypertension.
abstract: 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.
authors.affiliation: Hypertension and Cardiovascular Prevention Centre, ASL n.1-University of Sassari, Italy. glorioso@uniss.it
authors.forename: Nicola
authors.initials: N
authors.lastname: Glorioso
authors.forename: Fabiana
authors.initials: F
authors.lastname: Filigheddu
authors.forename: Paolo Pinna
authors.initials: PP
authors.lastname: Parpaglia
authors.forename: Aldo
authors.initials: A
authors.lastname: Soro
authors.forename: Chiara
authors.initials: C
authors.lastname: Troffa
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Argiolas
authors.forename: Paolo
authors.initials: P
authors.lastname: Mulatero
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D000450:Aldosterone; D013761:Tetrahydrocortisone; C009412:tetrahydro-11-deoxycortisol; D013760:Tetrahydrocortisol; D043209:11-beta-Hydroxysteroid Dehydrogenase Type 2; D012083:Renin; D003350:Cortodoxone