Significance of urinary angiotensinogen in essential hypertension as a function of plasma renin and aldosterone status

被引:16
作者
Lantelme, P
Rohrwasser, A
Vincent, M
Cheng, T
Gardier, S
Legedz, L
Bricca, G
Lalouel, JM
Milon, H
机构
[1] Hop Croix Rousse, Serv Cardiol, Fac Med Lyon Nord, F-69004 Lyon, France
[2] Univ Lyon 1, UMR MA 103, F-69365 Lyon, France
[3] Univ Utah, Hlth Sci Ctr, Dept Human Genet, Salt Lake City, UT USA
[4] Fac Med Grange Blanche, Physiol Lab, Lyon, France
[5] Fac Med Laennec, EA 3740, IFR 62, Lyon, France
关键词
hypertension; kidney; angiotensin;
D O I
10.1097/01.hjh.0000163147.20330.f5
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objective This study was performed to test the significance of urinary angiotensinoger (U-AGT) in essential hypertensive patients stratified as a function of plasma renin and aldosterone. Methods and results A sample of 248 essential hypertensives, investigated under their usual sodium diet and either off-medication or under a standardized treatment, was separated into two groups on the basis of upright plasma active renin and aldosterone medians. Patients with plasma active renin and aldosterone below medians are referred to as the low renin-aldosterone essential hypertensive group (LRA-EH). Others subjects are defined as other essential hypertensives (O-EH). Blood pressure (BP) was recorded by 24-h ambulatory monitoring. UAGT was measured by a specific enzyme-linked immunosorbent assay for total angiotensinogen. Because UAGT was markedly increased in the presence of overt proteinuria ( >= 300 mg/24 h), proteinuric patients (n = 29) were excluded from subsequent analyses. UAGT was a significant predictor of systolic and diastolic BP in LRA-EH females (P < 0.01 and P =: 0.05, respectively) but not in males. By contrast, urinary sodium excretion (P < 0.001) and maintenance of treatment (P = 0.002) were significant predictors of systolic BP in males. These correlations were not observed in O-EH, whether males or females. Conclusions In the present study, U-AGT stands as a strong predictor of BP in women with low plasma renin/aldosterone, suggesting an involvement of the tubular renin-angiotensin system in these subjects. Higher sodium intake or the need to maintain treatment may account in part for the lack of a similar relationship in males. (c) 2005 Lippincott Williams & Wilkins.
引用
收藏
页码:785 / 792
页数:8
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