title: Hormones other than aldosterone may contribute to hypertension in 3 different subtypes of primary aldosteronism.
abstract: Blood pressure (BP) level is similar in patients with 3 subtypes of primary aldosteronism (PA), even though aldosterone levels may vary. Glucocorticoids and adrenomedullary hormones may be influenced and may contribute to hypertension in PA. The authors' objective was to investigate the influence of PA on adrenal gland secretion and the roles of these hormones in hypertension. Patients diagnosed with PA (229 cases) were enrolled and classified into 3 subgroups: aldosterone-producing adenoma (APA), unilateral nodular adrenal hyperplasia (UNAH), and idiopathic hyperaldosteronism (IHA). Patients with essential hypertension served as the control group (100 cases). Concentration of the above hormones was measured and compared between groups. Level of plasma adrenocorticotrophic hormone (ACTH) in patients with APA was significantly lower than that in patients with IHA (P<.001) and UNAH (P<0.5). The 24-hour urinary free cortisol and adrenomedullary hormone levels were highest in patients with IHA, lower in patients with APA, and lowest in patients with UNAH. Systolic BP level was positively correlated with 8 am plasma cortisol level (r=0.142, P=.039) and plasma ACTH level (r=0.383, P=.016). Cortisol and adrenomedullary hormones were different between PA subtypes and they might involve regulation of BP in those patients.
authors.affiliation: Department of Endocrinology, Changzheng Hospital, Second Military Medical University, S197 Ruijing Er Road, Shanghai, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Ye
authors.forename: Zheng-Yi
authors.initials: ZY
authors.lastname: Tang
authors.forename: Jing-Cheng
authors.initials: JC
authors.lastname: Wu
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: Xiu-Li
authors.initials: XL
authors.lastname: Tian
authors.forename: Jia-Jia
authors.initials: JJ
authors.lastname: Huang
authors.forename: Shan-Shan
authors.initials: SS
authors.lastname: Zhang
authors.forename: Guang
authors.initials: G
authors.lastname: Ning
mesh_terms: D000313:Adrenal Medulla / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000450:Aldosterone / Q000378:metabolism* / Q000652:urine; D001795:Blood Pressure Determination; D005260:Female; D005938:Glucocorticoids / Q000378:metabolism* / Q000652:urine; D006801:Humans; D006929:Hyperaldosteronism / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D006965:Hyperplasia; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic
chemical_list: D005938:Glucocorticoids; D000450:Aldosterone
references.citation: J Hypertens. 2007 Jul;25(7):1433-42
references.pmid: 17563566
references.citation: Lancet. 1999 Jun 12;353(9169):2008-13
references.pmid: 10376615
references.citation: Hypertension. 2009 Apr;53(4):605-10
references.pmid: 19221213
references.citation: J Am Coll Cardiol. 2006 Dec 5;48(11):2293-300
references.pmid: 17161262
references.citation: J Nephrol. 2008 Jul-Aug;21(4):455-62
references.pmid: 18651533
references.citation: J Clin Endocrinol Metab. 2008 Sep;93(9):3266-81
references.pmid: 18552288
references.citation: Hypertension. 2006 Aug;48(2):232-8
references.pmid: 16801482
references.citation: Circulation. 1973 Sep;48(3):491-8
references.pmid: 4726231
references.citation: J Clin Endocrinol Metab. 2006 Feb;91(2):454-9
references.pmid: 16291704
references.citation: J Clin Endocrinol Metab. 2004 Mar;89(3):1045-50
references.pmid: 15001583
references.citation: QJM. 2008 Jan;101(1):13-22
references.pmid: 18203722
references.citation: J Endocrinol Invest. 1998 Sep;21(8):531-6
references.pmid: 9801995
references.citation: Eur J Endocrinol. 2004 Mar;150(3):329-37
references.pmid: 15012618
references.citation: J Hypertens. 2000 Apr;18(4):391-8
references.pmid: 10779088
references.citation: J Clin Hypertens (Greenwich). 2009 May;11(5):245-52
references.pmid: 19534021
references.citation: J Clin Endocrinol Metab. 2006 Jul;91(7):2618-23
references.pmid: 16670162
references.citation: Int J Hypertens. 2011 Jan 20;2011:837817
references.pmid: 21331160
references.citation: Arch Intern Med. 2008 Jan 14;168(1):80-5
references.pmid: 18195199
references.citation: J Hypertens. 2001 Jan;19(1):149-55
references.pmid: 11204296
references.citation: Nihon Naibunpi Gakkai Zasshi. 1976 Dec 20;52(12):1191-201
references.pmid: 201513
references.citation: Clin Endocrinol (Oxf). 2007 May;66(5):607-18
references.pmid: 17492946
references.citation: J Hypertens. 2006 Apr;24(4):737-45
references.pmid: 16531803
references.citation: JAMA. 2006 Jun 14;295(22):2638-45
references.pmid: 16772627
references.citation: Clin Exp Pharmacol Physiol. 2003 Jul;30(7):437-45
references.pmid: 12823256
references.citation: J Hypertens. 2007 Jan;25(1):177-86
references.pmid: 17143190
references.citation: J Clin Endocrinol Metab. 2006 Sep;91(9):3457-63
references.pmid: 16822818
references.citation: Am Heart J. 1978 Jul;96(1):97-109
references.pmid: 655118