6.1 Hypertension Associated with Obesity or Overweight: a Role for Aldosterone?
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High Blood Press Cardiovasc Prev 2008; 15 (3): 171-215 1120-9879/08/0003-0171/$48.00/0 © 2008 Adis Data Information BV. All rights reserved.
Hormonal Mechanisms 6.1 Hypertension Associated with Obesity or Overweight: a Role for Aldosterone? G.P. Rossi (1), A. Belfiore (2), G.P. Bernini (3), B. Fabris (4), G. Caridi (5), C. Ferri (6), G. Giacchetti (7), C. Letizia (8), M. Maccario (9), M. Mannelli (10), G. Palumbo (11), A. Patalano (12), D. Rizzoni (13), A.C. Pessina (1), F. Mantero (12), on behalf of PAPY Investigators ` di Padova, Padova; (2)Universita ` di Bari, (1)DMCS, Clinica Medica 4, Universita ` di Pisa, Pisa; (4)Universita ` di Trieste, Trieste; (5)Universita ` di Bari; (3)Universita ` de L’Aquila, L’Aquila; Reggio Calabria, Reggio Calabria; (6)Universita ` di Bari, Ancona; (8)Universita ` di Roma, Roma; (9)Universita ` di (7)Universita ` di Firenze, Firenze; (11)Universita ` di Legnano, Torino, Torino; (10)Universita ` di Legnano; (12)Dipartimento di Scienze Mediche e Chirurgiche, Universita ` di Brescia, Brescia, Italy Padova, Padova; (13)Universita Introduction. Body mass index (BMI) positively correlates with plasma aldosterone concentration (PAC) and urinary aldosterone excretion in normotensive subjects on a high sodium diet. However, whether such a correlation may exist in hypertensive patients and, moreover, whether it might be relevant for detection of primary aldosteronism (PA) remains unknown. Aim. To investigate whether (1) BMI may predict PAC and (2) BMI may affect PAC/plasma renin activity (PRA) (ARR) in hypertensive patients thereby affecting diagnostic accuracy of ARR in the discrimination of primary (essential) hypertension (PH) from PA. Methods. Hypertensive patients consecutively referring nationwide to specialized hypertension centres were prospectively enrolled and investigated for the following variables: BMI, daily sodium intake, PAC, PRA, ARR before and after captopril (50mg orally). Results. Complete biochemical data and a definite diagnosis were obtained in 1125 patients: of them, 999 had PH and 126 (11.2%) had PA. An aldosterone-producing adenoma was detected in 54 of PA patients (4,8%). Multivariate analysis showed that BMI can predict PAC (r= 0.153, p
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