Document Detail

Endogenous ouabain and the renin-angiotensin-aldosterone system: distinct effects on Na handling and blood pressure in human hypertension.
MedLine Citation:
PMID:  20842047     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate whether the renin-angiotensin-aldosterone system (RAAS) and endogenous ouabain system differently affect renal Na handling and blood pressure.
METHODS: Three hundred and one patients in whom we compared blood pressure, and renal Na tubular reabsorption in the basal condition and 2 h (T120) after saline infusion.
RESULTS: Following multivariate-adjusted linear and quartiles analysis, baseline mean blood pressure (MBP) was significantly higher (113.7 ± 1.33 mmHg) in the fourth versus the first endogenous ouabain quartile (103.8 ± 1.04 mmHg) and the trend across the quartiles was highly significant (β = 0.23, P = 3.53e-04). In contrast, an inverse relationship was present in the renin activity (PRA) quartiles with MBP highest in the first (112.5 ± 1.26) and lowest in the fourth PRA quartile (107.6 ± 1.48, P = 0.039). Following an acute saline load, changes in MBP and the slope of the pressure-natriuresis relationship were inversely related across the PRA quartiles. The fractional excretion of sodium (FENa) showed a negative linear trend going from the first to the third endogenous ouabain quartiles (2.35 ± 0.17 and 1.90 ± 0.14%, P = 0.05). Patients in the fourth endogenous ouabain quartile (>323 pmol/l) showed increased FENa T120 (2.78 ± 0.18%, P < 0.01) and increased Na tubular rejection fraction (P = 0.007) after Na load. After the saline load, there was a biphasic relationship between plasma endogenous ouabain and FENa favoring Na retention at low endogenous ouabain and Na excretion at high endogenous ouabain levels.
CONCLUSION: The RAAS and endogenous ouabain system are two independent and complementary systems having an inverse (RAAS) or a direct (endogenous ouabain system) relationship with hemodynamic parameters.
Paolo Manunta; John M Hamlyn; Marco Simonini; Elisabetta Messaggio; Chiara Lanzani; Maria Bracale; Giuseppe Argiolas; Nunzia Casamassima; Elena Brioni; Nicola Glorioso; Giuseppe Bianchi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  29     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2010-12-30     Completed Date:  2011-05-04     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  349-56     Citation Subset:  IM    
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MeSH Terms
Aldosterone / blood
Blood Pressure / physiology
Hypertension / blood,  physiopathology*
Kidney Tubules / physiopathology
Linear Models
Middle Aged
Natriuresis / physiology
Ouabain / blood*
Renin / blood
Renin-Angiotensin System / physiology*
Sodium / blood,  metabolism
Grant Support
078870//PHS HHS; HL75584/HL/NHLBI NIH HHS; P01 HL078870/HL/NHLBI NIH HHS; P01 HL078870-01/HL/NHLBI NIH HHS; R01 HL075584/HL/NHLBI NIH HHS; R01 HL075584-04/HL/NHLBI NIH HHS
Reg. No./Substance:
4964P6T9RB/Aldosterone; 5ACL011P69/Ouabain; 9NEZ333N27/Sodium; EC

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