title: Oxidative stress in patients affected by primary aldosteronism.
abstract: OBJECTIVE
  Primary aldosteronism, an important form of secondary hypertension, is associated with significant increase of cardiovascular risk (ischaemic heart, cerebrovascular events, arrhythmias) (relative risk 4.6). The specific treatment of primary aldosteronism significantly reduces cardiovascular risk. In addition to high blood pressure values and direct action of aldosterone, new mechanisms such as increased oxidative stress are involved in the development of organ damage, metabolic, endothelial and coagulation complications.
  
  
  METHODS
  The aim of the study was to evaluate parameters of oxidative stress in 38 patients (21 men, 17 women, mean age 53.3 ± 4.7 years) with primary aldosteronism [11 aldosterone-producing adenoma (APA) (4 men, 7 women, mean age 50.2 ± 4.5 years) and 27 idiopathic adrenal hyperplasia (IHA) (17 men, 10 women, mean age 54.5 ± 5.3 years)] at diagnosis and after specific treatment (surgical or pharmacological), with respect to 50 patients with essential hypertension (26 men, 24 women, mean age 49 ± 7.4 years) and 50 healthy individuals (28 men, 22 women, mean age 48.7 ± 4.4 years).
  
  
  RESULTS
  Patients with primary aldosteronism showed significant increase of NADPH oxidase (Nox2-dp) plasma levels and urinary isoprostanes (34.9 ± 4.3 μg/dl and 216.3 ± 15.7 ng/mg, respectively; P < 0.05) than essential hypertensive patients (27.1 ± 3.7 μg/dl and 144.8 ± 9.4 ng/mg, respectively; P < 0.05). In APA patients undergoing adrenalectomy, we observed significant reduction of both circulating levels of Nox2-dp (29 ± 2.1  vs. 22,4 ± 1.7 μg/dl; P < 0.05) and urinary levels of isoprostanes (221.1 ± 10.5 vs. 132.6 ± 8.7 ng/mg; P < 0.05).
  
  
  CONCLUSIONS
  This is the first study showing an increased oxidative stress in primary aldosteronism, characterized by increased serum levels of Nox2-dp and urinary excretion of isoprostanes. After APA removal with laparoscopic adrenalectomy, we found reduction of serum Nox2-dp and urinary isoprostanes.
authors: aInternal Medicine and Secondary Arterial Hypertension Unit bInternal Medicine Division, Department of Internal Medicine and Medical Specialties cDepartment of Surgery, 'P. Valdoni', University of Rome, 'Sapienza', Italy.
authors: Luigi
authors: L
authors: Petramala
authors: Pasquale
authors: P
authors: Pignatelli
authors: Roberto
authors: R
authors: Carnevale
authors: Laura
authors: L
authors: Zinnamosca
authors: Cristiano
authors: C
authors: Marinelli
authors: Amina
authors: A
authors: Settevendemmie
authors: Antonio
authors: A
authors: Concistrè
authors: Gianfranco
authors: G
authors: Tonnarini
authors: Giorgio
authors: G
authors: De Toma
authors: Francesco
authors: F
authors: Violi
authors: Claudio
authors: C
authors: Letizia
mesh_terms: D000236:Adenoma / Q000150:complications / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000378:metabolism*; D006973:Hypertension / Q000209:etiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D018384:Oxidative Stress; D012307:Risk Factors
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D000450:Aldosterone