Hormones Other Than Aldosterone May Contribute to Hypertension in 3 Different Subtypes of Primary Aldosteronism

Authors

  • Fei Ye MD,

    1. Department of Endocrinology, Changzheng Hospital, Second Military Medical University, Shanghai, China
    2. Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolism, Shanghai, China
    Search for more papers by this author
  • Zheng-Yi Tang MD, PhD,

    Corresponding author
    1. Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolism, Shanghai, China
    • Department of Endocrinology, Changzheng Hospital, Second Military Medical University, Shanghai, China
    Search for more papers by this author
  • Jing-Cheng Wu MD, PhD,

    1. Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolism, Shanghai, China
    Search for more papers by this author
  • Yang Yang MD,

    1. Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolism, Shanghai, China
    Search for more papers by this author
  • Xiu-Li Tian MD,

    1. Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolism, Shanghai, China
    Search for more papers by this author
  • Jia-Jia Huang MD,

    1. Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolism, Shanghai, China
    Search for more papers by this author
  • Shan-Shan Zhang MD,

    1. Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolism, Shanghai, China
    Search for more papers by this author
  • Guang Ning MD, PhD;

    1. Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolism, Shanghai, China
    Search for more papers by this author

Address for correspondence: Zheng-Yi Tang, MD, PhD, Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-tong University School of Medicine, 197 Ruijing Er Road, Shanghai, 200025, China

E-mail: tsy2zyp@163.com

Abstract

Blood pressure (BP) level is similar in patients with 3 subtypes of primary aldosteronism (PA), even though aldosterone levels may vary. Glucocorticoids and adrenomedullary hormones may be influenced and may contribute to hypertension in PA. The authors' objective was to investigate the influence of PA on adrenal gland secretion and the roles of these hormones in hypertension. Patients diagnosed with PA (229 cases) were enrolled and classified into 3 subgroups: aldosterone-producing adenoma (APA), unilateral nodular adrenal hyperplasia (UNAH), and idiopathic hyperaldosteronism (IHA). Patients with essential hypertension served as the control group (100 cases). Concentration of the above hormones was measured and compared between groups. Level of plasma adrenocorticotrophic hormone (ACTH) in patients with APA was significantly lower than that in patients with IHA (P<.001) and UNAH (P<0.5). The 24-hour urinary free cortisol and adrenomedullary hormone levels were highest in patients with IHA, lower in patients with APA, and lowest in patients with UNAH. Systolic BP level was positively correlated with 8 am plasma cortisol level (r=0.142, P=.039) and plasma ACTH level (r=0.383, P=.016). Cortisol and adrenomedullary hormones were different between PA subtypes and they might involve regulation of BP in those patients.

Ancillary