title: Association Between Pituitary-Adrenal Axis Dominance Over the Renin-Angiotensin-Aldosterone System and Hypertension.
abstract: BACKGROUND
  The hypothalamus-pituitary-adrenal (HPA) axis and the renin-angiotensin aldosterone system (RAAS) are well known to be associated with hypertension. However, the extent of the effects is not yet well elucidated in general conditions.
  
  
  OBJECTIVE
  To separately determine the effect of the HPA axis and the RAAS on hypertension in a general population.
  
  
  METHODS
  A population-based study of 859 Japanese individuals enrolled in the 2014 Iwaki study and without hypertension or steroid treatment (age, 50.2 ± 14.7 years).
  
  
  METHODS
  Hypertension prevalence, plasma concentration of aldosterone, ACTH, cortisol, and plasma renin activity.
  
  
  RESULTS
  Principal component (PC) analysis using these four hormones identified two PCs (PC1 and PC2), which represent levels of these hormones as a whole, and dominance between the HPA axis (ACTH and cortisol) and the RAAS (plasma renin activity and plasma concentration of aldosterone), respectively. Association between these PCs and hypertension was significant (PC1, high vs low, odds ratio [OR], 1.48; 95% confidence interval [CI], 1.09-2.02; and PC2, HPA axis vs RAAS dominancy, OR, 2.08; and 95% CI, 1.51-2.85). However, association between the hormone levels as a whole and hypertension became insignificant after adjustment for multiple factors including these PCs together. However, association between the HPA axis dominance and hypertension remained significant even after the adjustment (the HPA axis vs the RAAS, OR, 1.73; 95% CI, 1.20-2.48).
  
  
  CONCLUSIONS
  The HPA axis dominance over the RAAS is significantly associated with hypertension in a Japanese population.
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Daimon
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Kamba
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Otaka
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Koushi
authors.initials: K
authors.lastname: Makita
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Yanagimachi
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Terui
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kageyama
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nigawara
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Sawada
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Takahashi
authors.affiliation: Departments of Endocrinology and Metabolism (M.D., A.K., H.M., K.Ta., H.O., K.M., M.Y., K.Te., K.K., T.N.), and Social Medicine (K.S., I.T., S.N.), Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Nakaji
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D025341:Principal Component Analysis; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000502:physiology*
chemical_list: D000450:Aldosterone; D000324:Adrenocorticotropic Hormone; D012083:Renin