Aldosterone, Hypertension, and Antihypertensive Therapy: Insights From a General Population

Valentina Cannone, Alessia Buglioni, S Jeson Sangaralingham, Christopher Scott, Kent R Bailey, Richard Rodeheffer, Margaret May Redfield, Riccardo Sarzani, John C Jr. Burnett

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4 Citations (Scopus)

Abstract

Objective: To investigate the relationships among aldosterone level, use of antihypertensive (anti-HTN) medications, clinical profile, and atrial natriuretic peptide (ANP) level in individuals with HTN. Participants and Methods: In a community-based cohort, we analyzed aldosterone plasma levels based on the presence (n=477) or absence (n=1073) of HTN. In individuals with HTN, we evaluated circulating aldosterone levels according to the number of anti-HTN drugs used, analyzed the associated clinical characteristics, and determined the relationship to the counterregulatory cardiac hormone ANP. Data were collected from August 25, 1997, through September 5, 2000. Results: Participants with HTN had higher serum aldosterone levels than those without HTN (6.4 vs 4.1 ng/dL [to convert to pmol/L, multiply by 27.74]; P<.001). When individuals with HTN were stratified according to the number of anti-HTN medications used, the increase in number of medications (0, 1, 2, and ≥3) was associated with higher aldosterone levels (4.8, 6.4, 7.10, and 7.9 ng/dL, respectively; P=.002), worse metabolic profile, and higher prevalence of cardiovascular, renal, and metabolic disease. In participants with HTN, ANP plasma levels were inversely related to aldosterone levels when the latter was divided into tertiles. Conclusion: In this randomly selected general population cohort, aldosterone levels were higher in individuals with HTN compared with normotensive participants. Aldosterone levels increased with anti-HTN medication use. These findings also suggest a relative ANP deficiency with increasing aldosterone levels and anti-HTN drug use. These studies have pathophysiologic and therapeutic implications for targeting aldosterone in the clinical treatment of HTN.

Original languageEnglish (US)
Pages (from-to)980-990
Number of pages11
JournalMayo Clinic Proceedings
Volume93
Issue number8
DOIs
StatePublished - Aug 1 2018

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Aldosterone
Antihypertensive Agents
Hypertension
Population
Atrial Natriuretic Factor
Therapeutics
Metabolome
Metabolic Diseases
Cardiovascular Diseases
Hormones
Kidney

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Aldosterone, Hypertension, and Antihypertensive Therapy : Insights From a General Population. / Cannone, Valentina; Buglioni, Alessia; Sangaralingham, S Jeson; Scott, Christopher; Bailey, Kent R; Rodeheffer, Richard; Redfield, Margaret May; Sarzani, Riccardo; Burnett, John C Jr.

In: Mayo Clinic Proceedings, Vol. 93, No. 8, 01.08.2018, p. 980-990.

Research output: Contribution to journalArticle

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abstract = "Objective: To investigate the relationships among aldosterone level, use of antihypertensive (anti-HTN) medications, clinical profile, and atrial natriuretic peptide (ANP) level in individuals with HTN. Participants and Methods: In a community-based cohort, we analyzed aldosterone plasma levels based on the presence (n=477) or absence (n=1073) of HTN. In individuals with HTN, we evaluated circulating aldosterone levels according to the number of anti-HTN drugs used, analyzed the associated clinical characteristics, and determined the relationship to the counterregulatory cardiac hormone ANP. Data were collected from August 25, 1997, through September 5, 2000. Results: Participants with HTN had higher serum aldosterone levels than those without HTN (6.4 vs 4.1 ng/dL [to convert to pmol/L, multiply by 27.74]; P<.001). When individuals with HTN were stratified according to the number of anti-HTN medications used, the increase in number of medications (0, 1, 2, and ≥3) was associated with higher aldosterone levels (4.8, 6.4, 7.10, and 7.9 ng/dL, respectively; P=.002), worse metabolic profile, and higher prevalence of cardiovascular, renal, and metabolic disease. In participants with HTN, ANP plasma levels were inversely related to aldosterone levels when the latter was divided into tertiles. Conclusion: In this randomly selected general population cohort, aldosterone levels were higher in individuals with HTN compared with normotensive participants. Aldosterone levels increased with anti-HTN medication use. These findings also suggest a relative ANP deficiency with increasing aldosterone levels and anti-HTN drug use. These studies have pathophysiologic and therapeutic implications for targeting aldosterone in the clinical treatment of HTN.",
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AU - Scott, Christopher

AU - Bailey, Kent R

AU - Rodeheffer, Richard

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