Weight loss and the renin-angiotensin-aldosterone system.
The renin-angiotensin-aldosterone system has been causally implicated in obesity-associated hypertension. We studied the influence of obesity and weight reduction on the circulating and adipose tissue renin-angiotensin-aldosterone system in menopausal women. Blood samples were analyzed for angiotensinogen, renin, aldosterone, angiotensin-converting enzyme activity, and angiotensin II. In adipose tissue biopsy samples, we analyzed angiotensinogen, renin, renin-receptor, angiotensin-converting enzyme, and angiotensin II type-1 receptor gene expression. Obese women (n=19) had higher circulating angiotensinogen, renin, aldosterone, and angiotensin-converting enzyme than lean women (n=19), and lower angiotensinogen gene expression in adipose tissue. Seventeen women successfully participated in a weight reduction protocol over 13 weeks to reduce daily caloric intake by 600 kcal. Body weight was reduced by -5%, as were angiotensinogen levels by -27%, renin by -43%, aldosterone by -31%, angiotensin-converting enzyme activity by -12%, and angiotensinogen expression by -20% in adipose tissue (all P<0.05). The plasma angiotensinogen decrease was highly correlated with the waist circumference decline (r=0.74; P<0.001). Weight and renin-angiotensin-aldosterone system reductions were accompanied by a -7-mm Hg reduced systolic ambulatory blood pressure. These data suggest that a 5% reduction in body weight can lead to a meaningfully reduced renin-angiotensin-aldosterone system in plasma and adipose tissue, which may contribute to the reduced blood pressure.
Engeli
Stefan
S
Medical Faculty of the Charité, Franz Volhard Clinic and Max Delbrück Center for Molecular Medicine, HELIOS-Klinikum, Berlin, Germany. engeli@fvk.charite-buch.de
Böhnke
Jana
J
Gorzelniak
Kerstin
K
Janke
Jürgen
J
Schling
Petra
P
Bader
Michael
M
Luft
Friedrich C
FC
Sharma
Arya M
AM
D000273:Adipose Tissue / Q000378:metabolism; D000450:Aldosterone / Q000097:blood / Q000378:metabolism*; D000808:Angiotensinogen / Q000097:blood / Q000378:metabolism; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000503:physiopathology* / Q000628:therapy; D007703:Peptidyl-Dipeptidase A / Q000097:blood; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System; D015431:Weight Loss
D000808:Angiotensinogen; D000450:Aldosterone; D007703:Peptidyl-Dipeptidase A; D012083:Renin