title: Iron Stores, Hepcidin, and Aortic Stiffness in Individuals with Hypertension.
abstract: OBJECTIVE
  Iron accumulation within the arterial wall has been hypothesized to promote atherosclerosis progression. Aim of this study was to evaluate whether the hormone hepcidin and iron stores are associated with arterial stiffness in subjects with essential hypertension.
  
  
  METHODS
  Circulating hepcidin, ferritin, and mutations in the hemochromatosis gene were compared between subjects included in the first vs. third tertile (n=284 each) of carotid-femoral pulse wave velocity (PWV) in an unselected cohort of patients with arterial hypertension.
  
  
  RESULTS
  At univariate logistic regression analysis, high PWV was associated with higher ferritin levels (p=0.010), but lower hepcidin (p=0.045), and hepcidin ferritin/ratio (p<0.001). Hemochromatosis mutations predisposing to iron overload were associated with high PWV (p=0.025). At multivariate logistic regression analysis, high aortic stiffness was associated with older age, male sex, lower BMI, higher systolic blood pressure and heart rate, hyperferritinemia (OR 2.05, 95% c.i. 1.11-3.17 per log ng/ml; p=0.022), and lower circulating hepcidin concentration (OR 0.29, 95% c.i. 0.16-0.51 per log ng/ml; p<0.001). In subgroup analyses, high PWV was associated with indices of target organ damage, including micro-albuminuria (n=125, p=0.038), lower ejection fraction (n=175, p=0.031), cardiac diastolic dysfunction (p=0.004), and lower S wave peak systolic velocity (p<0.001). Ferritin was associated with cardiac diastolic dysfunction, independently of confounders (p=0.006).
  
  
  CONCLUSIONS
  In conclusion, hyperferritinemia is associated with high aortic stiffness and cardiac diastolic dysfunction, while low circulating hepcidin with high aortic stiffness.
authors.affiliation: Internal Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Valenti
authors.affiliation: Cardiology IV, De Gasperi Department, Niguarda Ca' Granda Hospital, and Medicine Department, Università Milano Bicocca, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Maloberti
authors.affiliation: Laboratory Medicine, Desio Hospital, Università Milano Bicocca, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Signorini
authors.affiliation: Internal Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Milano
authors.affiliation: Cardiology IV, De Gasperi Department, Niguarda Ca' Granda Hospital, and Medicine Department, Università Milano Bicocca, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cesana
authors.affiliation: Laboratory Medicine, Desio Hospital, Università Milano Bicocca, Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Cappellini
authors.affiliation: Internal Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Dongiovanni
authors.affiliation: Internal Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Porzio
authors.affiliation: Cardiology IV, De Gasperi Department, Niguarda Ca' Granda Hospital, and Medicine Department, Università Milano Bicocca, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Soriano
authors.affiliation: Laboratory Medicine, Desio Hospital, Università Milano Bicocca, Milan, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Brambilla
authors.affiliation: General Direction, Fondazione IRCCS Ca' Granda Ospedale Policlinico, Research Centre on Public Health, University Milano Bicocca, Milan, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Cesana
authors.affiliation: Laboratory Medicine, Desio Hospital, Università Milano Bicocca, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Brambilla
authors.affiliation: Cardiology IV, De Gasperi Department, Niguarda Ca' Granda Hospital, and Medicine Department, Università Milano Bicocca, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Giannattasio
authors.affiliation: Internal Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Fargion
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology; D000075222:Essential Hypertension; D005260:Female; D005293:Ferritins / Q000097:blood*; D064451:Hepcidins / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000503:physiopathology; D007501:Iron / Q000097:blood*; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness
chemical_list: D064451:Hepcidins; D005293:Ferritins; D007501:Iron