The influence of aldosterone on the development of left ventricular geometry and hypertrophy in patients with essential hypertension.

The identification of risk factors for the initiation of left ventricle hypertrophy (LVH), which is an independent risk factor for cardiovascular mortality and morbidity in hypertensive patients, is very important. The objective of the present study was to identify the relationship of aldosterone with LVH and different geometrical patterns of left ventricle that develop in patients with essential hypertension. A total of 83 patients with essential hypertension (44 females, mean age, 51 +/- 8 years, 39 males, mean age, 57 +/- 10 years) were included in this study. Thirty-two had LVH. When evaluated according to the geometrical patterns of LVH, 18 patients had concentric LVH, 14 had eccentric LVH, and 17 had concentric remodeling. Thirty-four patients had normal left ventricle geometry. Two weeks after the cessation of antihypertensive medications, sodium, potassium, and proteinuria in 24-hour urine samples and plasma aldosterone levels and plasma renin activity were measured. Plasma aldosterone levels of the patients with LVH were found to be significantly higher (9.92 +/- 6.34 ng/dL versus 5.83 +/- 3.5 ng/dL, P < 0.01). The difference between plasma renin activities was not statistically significant. Linear regression analysis revealed that plasma aldosterone level and age were independent parameters increasing left ventricle mass index. The plasma aldosterone levels of patients with concentric hypertrophy of the left ventricle were significantly higher than those of patients with normal geometry and concentric remodeling. There was no significant difference between plasma renin activities. Twenty-four hour urine protein concentrations of the patients with LVH were found to be significantly higher and sodium to be significantly lower. Plasma aldosterone levels seem to be correlated with LVH especially with concentric hypertrophy of the left ventricle in patients with essential hypertension.

[1]  N. Yamamoto,et al.  Aldosterone Is Produced From Ventricles in Patients With Essential Hypertension , 2002, Hypertension.

[2]  I. Miyamori,et al.  Cardiac Aldosterone Production in Genetically Hypertensive Rats , 2000, Hypertension.

[3]  A. Carayon,et al.  , Brigitte Angiotensin II Receptor Blockade and Role in Cardiac Fibrosis Activation of Cardiac Aldosterone Production in Rat Myocardial Infarction : Effect of , 1999 .

[4]  A. Danser,et al.  Localization and production of angiotensin II in the isolated perfused rat heart. , 1998, Hypertension.

[5]  H. Schunkert,et al.  Neurohormonal activity and left ventricular geometry in patients with essential arterial hypertension. , 1998, American heart journal.

[6]  R. Schmieder,et al.  Angiotensin II related to sodium excretion modulates left ventricular structure in human essential hypertension. , 1996, Circulation.

[7]  H. Schunkert,et al.  Angiotensin II-induced growth responses in isolated adult rat hearts. Evidence for load-independent induction of cardiac protein synthesis by angiotensin II. , 1995, Circulation research.

[8]  D. Reda,et al.  Importance of obesity, race and age to the cardiac structural and functional effects of hypertension. The Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents. , 1994, Journal of the American College of Cardiology.

[9]  N. Schork,et al.  Sex‐Specific Determinants of Increased Left Ventricular Mass in the Tecumseh Blood Pressure Study , 1994, Circulation.

[10]  H. Schunkert,et al.  Distribution and Functional Significance of Cardiac Angiotensin Converting Enzyme in Hypertrophied Rat Hearts , 1993, Circulation.

[11]  J. Kaufman,et al.  Influence of arterial blood pressure and aldosterone on left ventricular hypertrophy in moderate essential hypertension. , 1993, The American journal of cardiology.

[12]  K. Weber,et al.  Reactive and reparative myocardial fibrosis in arterial hypertension in the rat. , 1992, Cardiovascular research.

[13]  J. Laragh,et al.  Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. , 1992, Journal of the American College of Cardiology.

[14]  T. Risler,et al.  Renal haemodynamics and organ damage in young hypertensive patients with different plasma renin activities after ACE inhibition. , 1992, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[15]  K. Weber,et al.  Pathological Hypertrophy and Cardiac Interstitium: Fibrosis and Renin‐Angiotensin‐Aldosterone System , 1991, Circulation.

[16]  J. Laragh,et al.  Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. , 1991, Annals of internal medicine.

[17]  J. Laragh,et al.  Echocardiographic left ventricular mass and electrolyte intake predict arterial hypertension. , 1991, Annals of internal medicine.

[18]  A. Labovitz,et al.  Echocardiographic evaluation of cardiac structure and function in elderly subjects with isolated systolic hypertension. , 1991, Journal of the American College of Cardiology.

[19]  K. Baker,et al.  Cardiac Hypertrophy: Mechanical, Neural, and Endocrine Dependence , 1991 .

[20]  G. Stokes,et al.  Interactions between enalaprilat and doxazosin at rat tail artery alpha 1-adrenoceptors. , 1991, Journal of cardiovascular pharmacology.

[21]  F. Leenen,et al.  Antihypertensive drugs and cardiac trophic mechanisms. , 1991, Journal of cardiovascular pharmacology.

[22]  D. Levy.  Clinical significance of left ventricular hypertrophy: insights from the Framingham Study. , 1991, Journal of cardiovascular pharmacology.

[23]  J. Loggie,et al.  Determinants of cardiac involvement in children and adolescents with essential hypertension. , 1990, Circulation.

[24]  J. C. Christiansen,et al.  Determinants of sensitivity and specificity of electrocardiographic criteria for left ventricular hypertrophy. , 1990, Circulation.

[25]  E. Frohlich,et al.  Left ventricular hypertrophy, cardiac diseases and hypertension: recent experiences. , 1989, Journal of the American College of Cardiology.

[26]  M. Mancini,et al.  Adrenergic nervous system and left ventricular mass in primary hypertension. , 1989, European heart journal.

[27]  H. Zimmer,et al.  Significance of myocardial alpha- and beta-adrenoceptors in catecholamine-induced cardiac hypertrophy. , 1989, Circulation research.

[28]  N. Reichek,et al.  Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. , 1989, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[29]  R. Wise,et al.  Antihypertensive Drug Use Trends in the United States From 1973 to 1985 , 1989, Hypertension.

[30]  Ralph B. D'Agostino,et al.  Blood Pressure as a Risk Factor for Cardiovascular Disease The Framingham Study—30 Years of Follow‐up , 1989, Hypertension.

[31]  M. Kuramochi,et al.  Left ventricular structural characteristics in unilateral renovascular hypertension and primary aldosteronism. , 1988, American Journal of Cardiology.

[32]  J. Laragh,et al.  Value of echocardiographic measurement of left ventricular mass in predicting cardiovascular morbid events in hypertensive men. , 1986, Annals of internal medicine.

[33]  N. Reichek,et al.  Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. , 1986, The American journal of cardiology.

[34]  J. Ingwall,et al.  Effects of Moderate Pressure Overload Cardiac Hypertrophy on The Distribution of Creatine Kinase Isozymes 1 , 1984, Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine.

[35]  R. Tarazi,et al.  Regression of myocardial hypertrophy and influence of adrenergic system. , 1983, The American journal of physiology.

[36]  J. Laragh,et al.  Left Ventricular Hypertrophy and Function in High, Normal, and Low‐Renin Forms of Essential Hypertension , 1982, Hypertension.

[37]  R R Miller,et al.  A New, Simplified and Accurate Method for Determining Ejection Fraction with Two‐dimensional Echocardiography , 1981, Circulation.

[38]  I. Ostman-Smith.  Cardiac sympathetic nerves as the final common pathway in the induction of adaptive cardiac hypertrophy. , 1981, Clinical science.

[39]  W Grossman,et al.  Wall stress and patterns of hypertrophy in the human left ventricle. , 1975, The Journal of clinical investigation.

[40]  A. Chanutin,et al.  EXPERIMENTAL RENAL INSUFFICIENCY PRODUCED BY PARTIAL NEPHRECTOMY: II. RELATIONSHIP OF LEFT VENTRICULAR HYPERTROPHY, THE WIDTH OF THE CARDIAC MUSCLE FIBER AND HYPERTENSION IN THE RAT , 1933 .