Document Detail

Urinary cortisol to cortisone metabolites ratio in prednisone-treated and spontaneously hypertensive patients.
MedLine Citation:
PMID:  18300859     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE AND METHODS: Prednisone and its active metabolite prednisolone, both substrates for 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2), may represent a pharmacological challenge for the enzyme. The aim of the present work was to define the possible role of abnormal cortisol/cortisone handling, as revealed by an urinary tetrahydrocortisol + allotetrahydrocortisol (THFs)/tetrahydrocortisone (THE) ratio between 1.5 and 3.0, by measuring urinary cortisol and cortisone metabolites in: normotensive individuals (n = 100) who received 7-8 mg/day of oral prednisone and were then followed for development of hypertension; essential hypertensive (EH) participants from primary care (n = 103); and EH hypertensive patients referred to the Hypertension Unit (n = 141). RESULTS: About one-third (14 out of 47, 30%) of glucorticoid-treated patients who developed hypertension showed a THFs/THE ratio >1.5, which was seen in 3% (n = 3) and 14% (n = 19) of primary and tertiary care hypertensive patients, respectively. A THFs/THE ratio >1.5 was associated with a 3.8-fold incremental risk of hypertension after glucocorticoid therapy, regardless of duration and intensity of prednisone therapy. CONCLUSIONS: A number of EH patients and glucocorticoid-treated participants shared a similar phenotype, characterized by both arterial hypertension and elevated urinary THFs/THE ratio. Such a phenotype is more common in severely, rather than in mildly, hypertensive patients.
Oliviero Olivieri; Francesca Pizzolo; Viviana Ravagnani; Lorenzo Moretti; Antonio Carletto; Giovanni Faccini; Francesco Pasini; Simonetta Friso; Roberto Corrocher
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  26     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-27     Completed Date:  2008-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  486-93     Citation Subset:  IM    
Unit of Internal Medicine, Department of Clinical and Experimental Medicine, University of Verona, Italy.
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MeSH Terms
Cortisone / urine*
Glucocorticoids / adverse effects*
Hydrocortisone / metabolism,  urine*
Hypertension / chemically induced*,  urine
Middle Aged
Prednisone / adverse effects*
Risk Factors
Reg. No./Substance:
0/Glucocorticoids; 50-23-7/Hydrocortisone; 53-03-2/Prednisone; 53-06-5/Cortisone

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