Low-Renin Hypertension With Relative Aldosterone Excess Is Associated With Impaired NO-Mediated Vasodilation

Recent studies suggest that hypertension associated with low renin status and hyperaldosteronism is associated with increased risk for end-organ damage and cardiovascular events compared with other forms of hypertension. Additionally, experimental studies have demonstrated impaired nitric oxide-medi...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2005-10, Vol.46 (4), p.707-713
Main Authors: Duffy, Stephen J, Biegelsen, Elizabeth S, Eberhardt, Robert T, Kahn, David F, Kingwell, Bronwyn A, Vita, Joseph A
Format: Article
Language:English
Subjects:
Adult
Aged
Aldosterone - blood
Case-Control Studies
Female
Forearm - blood supply
Humans
Hyperaldosteronism - complications
Hypertension - blood
Hypertension - complications
Hypertension - physiopathology
Male
Middle Aged
Nitric Oxide - metabolism
Prospective Studies
Renin - blood
Vascular Resistance
Vasodilation
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Summary:Recent studies suggest that hypertension associated with low renin status and hyperaldosteronism is associated with increased risk for end-organ damage and cardiovascular events compared with other forms of hypertension. Additionally, experimental studies have demonstrated impaired nitric oxide-mediated bioactivity in these states. To investigate the relation between renin/aldosterone status and resistance vessel function, we examined plasma renin activity, serum aldosterone level, and forearm blood flow responses to the endothelium-dependent vasodilator methacholine and the endothelium-independent vasodilators sodium nitroprusside and verapamil using venous occlusion plethysmography in 130 volunteers (43 hypertensive, 87 normotensive). Low renin status was associated with impaired responses to methacholine and nitroprusside in patients with hypertension. Peak methacholine response was 8.7±5.6 mL/min per dL in the lowest renin quartile (0.1 to 0.3 ng/mL per hour) versus 14.3±7.3 mL/min per dL in the highest 3 renin quartiles combined (0.4 to 4.6 ng/mL per hour; P
ISSN:0194-911X
1524-4563
DOI:10.1161/01.HYP.0000184231.84465.62