| Relation between the renin-angiotensin-aldosterone system and left ventricular structure and function in young normotensive and mildly hypertensive subjects. | |
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MedLine Citation:
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PMID: 10539810 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: High angiotensin II levels in relation to the corresponding urinary sodium excretion have been found to modulate left ventricular (LV) structure in middle-aged hypertensive patients. To analyze whether such a relation between the renin-angiotensin-aldosterone system and left ventricular structure is already present in young individuals, we examined the changes of angiotensin II and aldosterone in response to increased salt intake and their relations to LV structure and function. METHODS: In 119 young (aged 26 +/- 3 years) patients with normal or mildly elevated blood pressure, we determined LV structure and function (2-dimensional guided M-mode echocardiography and pulse wave Doppler sonography) and 24-hour ambulatory blood pressure (SpaceLabs 90207). Dietary sodium intake as estimated by 24-hour urinary sodium excretion, plasma renin activity, angiotensin II, and aldosterone concentrations were measured first on a normal diet and second at high salt intake to determine the extent of the resulting suppression of the renin-angiotensin-aldosterone system. RESULTS: Body mass index (r = 0.43, P <.001) and both systolic (r = 0.24, P <. 01) and diastolic (r = 0.19, P <.05) 24-hour ambulatory blood pressure correlated with LV mass. No straightforward relation was found between LV structure and baseline angiotensin II or aldosterone concentration. The increase of sodium excretion at high salt intake was related to a physiologically expected decrease of angiotensin II and aldosterone levels in normotensive (r = -0.36, P <.01 and r = -0.32; P =.016, respectively) but not in hypertensive patients. Changes in angiotensin II or aldosterone concentration were not related to LV structure in either hypertensive or normotensive young individuals. However, changes in aldosterone secretion correlated with diastolic filling parameters in hypertensive patients (velocity-time integrals of the A over E wave: r = 0.32, P =.03; atrial contribution of LV filling: r = 0.33, P =. 025) but not in normotensive individuals. CONCLUSION: In contrast to middle-aged hypertensive patients, neither angiotensin II, aldosterone, nor their suppression in response to high salt intake were related to LV structure in young hypertensive patients. However, inadequate suppression of aldosterone after salt intake was associated with diastolic filling abnormalities in our young hypertensive patients, which may represent early changes in hypertensive heart disease and precede potential structural alterations. |
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Authors:
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M P Schlaich; A Klingbeil; K Hilgers; H P Schobel; R E Schmieder |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American heart journal Volume: 138 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1999 Nov |
Date Detail:
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Created Date: 1999-11-19 Completed Date: 1999-11-19 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 810-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine IV/Nephrology, University of Erlangen-Nürnberg, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aldosterone / blood Angiotensin II / blood Blood Flow Velocity / drug effects, physiology Blood Pressure / drug effects, physiology Blood Pressure Monitoring, Ambulatory Echocardiography Heart Ventricles / ultrasonography* Humans Hypertension / metabolism*, physiopathology Male Myocardial Contraction / drug effects, physiology Radioimmunoassay Renin / blood Renin-Angiotensin System / drug effects, physiology* Sodium / urine Sodium, Dietary / pharmacokinetics Ultrasonography, Doppler, Pulsed Ventricular Function Ventricular Function, Left / physiology* |
| Chemical | |
Reg. No./Substance:
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0/Sodium, Dietary; 11128-99-7/Angiotensin II; 52-39-1/Aldosterone; 7440-23-5/Sodium; EC 3.4.23.15/Renin |
| Comments/Corrections | |
Comment In:
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Am Heart J. 2000 Oct;140(4):E19-20
[PMID:
11011316
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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