title: Hypoadiponectinemia and aldosterone excess are associated with lack of blood pressure control in subjects with resistant hypertension.
abstract: Obesity, arterial stiffness and high aldosterone levels can interact to cause resistant hypertension (RHTN). Lower adiponectin (APN) levels may be significantly associated with hypertension. However, the importance of hypoadiponectinemia as a complicating factor in the lack of blood pressure (BP) control in individuals with RHTN has not been demonstrated. Ninety-six RHTN patients were classified into uncontrolled (UCRHTN, n = 44) and controlled (CRHTN, n = 52) subgroups. Their APN and aldosterone levels, office and ambulatory BP (ABPM) measurements, endothelium-dependent brachial artery responses (flow-mediated dilation (FMD)), left ventricular mass index (LVMI) and pulse wave velocity (PWV) were evaluated. The UCRHTN subgroup had increased aldosterone levels, as well as higher LVMI and PWV. In addition, lower APN levels and impaired FMD response were found in this subgroup. The brachial and ABPM pulse pressures were inversely associated with the APN levels (r = -0.45, P = 0.002; r = -0.33, P = 0.03, respectively), as were the aldosterone levels and the PWV (r = -0.38, P = 0.01; r = -0.36, P = 0.02, respectively) in UCRHTN patients. The PWV was only significantly influenced by the APN level in the UCRHTN subgroup in the multivariate regression analysis. None of the correlations mentioned above were observed in the CRHTN subgroup. Hypoadiponectinemia and high aldosterone levels may therefore be implicated in resistance to antihypertensive therapy related to arterial stiffness.
authors: Laboratory of Cardiovascular Pharmacology, Faculty of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil.
authors: Ana P C
authors: AP
authors: de Faria
authors: Caroline
authors: C
authors: Demacq
authors: Valéria N
authors: VN
authors: Figueiredo
authors: Carolina H
authors: CH
authors: Moraes
authors: Rodrigo C
authors: RC
authors: Santos
authors: Andréa R
authors: AR
authors: Sabbatini
authors: Natália R
authors: NR
authors: Barbaro
authors: Leandro
authors: L
authors: Boer-Martins
authors: Vanessa
authors: V
authors: Fontana
authors: Heitor
authors: H
authors: Moreno
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000367:Age Factors; D001774:Blood Chemical Analysis; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004351:Drug Resistance; D004452:Echocardiography; D004730:Endothelium, Vascular / Q000502:physiology; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood*; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
chemical_list: D052242:Adiponectin