Content area
Full Text
Summary
Primary aldosteronism (PA) is the most common cause of endocrine hypertension with a high frequency of cardiovascular complications. The unfavorable cardiometabolic profile may be due to aldosterone-mediated activation of inflammatory cells, circulatory cytokines and activation of collagen synthesis in the vessel wall. Aim of our study was to evaluate differences in the levels of hsCRP, IL-6, TNF-α and N-terminal propeptide of collagen I (PINP) in patients with PA and essential hypertension (EH) as a control group, and between the subtypes of PA (aldosterone producing adenoma - APA, idiopathic hyperaldosteronism - IHA). We studied 28 patients with PA (IHA - 10 patients, APA - 12 patients, 6 unclassified) and 28 matched patients with EH. There were no differences in the levels of inflammatory markers between the followed groups [EH vs. PA: TNF-α (5.09 [3.68-6.32] vs. 4.84 [3.62-6.50] pg/ml), IL-6 (0.94 [0.70-1.13] vs. 0.97 [0.711.28] pg/ml), hsCRP (0.53 [0.25-1.54] vs. 0.37 [0.31-0.61] mg/l), leukocytes (6.35±1.42 vs. 5.97±1.29 109 l); APA vs. IHA: TNF-α (4.54 [3.62-7.03] vs. 5.19 [4.23-5.27] pg/ml), IL-6 (0.96 [0.631.21] vs. 0.90 [0.65-1.06] pg/ml), hsCRP (0.34 [0.29-0.47] vs. 0.75 [0.36-1.11] mg/l), leukocytes (6.37±1.41 vs. 5.71±1.21 109 l)]. Significant differences in the levels of PINP between PA and EH group were observed (35.18 [28.46-41.16] vs. 45.21 [36.95-62.81] μg/l, p≤0.003). No differences in inflammatory markers were observed between the followed groups, we confirmed higher levels of PINP in patients with PA.
Key words
Primary aldosteronism * TNF-α * IL-6 * hsCRP * PINP
Introduction
Primary aldosteronism (PA) characterized by autonomous overproduction of aldosterone is the most common cause of endocrine hypertension with a high frequency of cardiovascular complications. The prevalence PA in the non-selected hypertensive population is around 5-13 % (Young 2007, Hannemann and Wallaschofski 2012) and in a preselected population of patients with severe and resistant hypertension around 20 % (Calhoun et al. 2002, Strauch et al. 2003). The main forms of PA are idiopathic aldosteronism (IHA) caused by bilateral adrenal hyperplasia and unilateral aldosterone producing adenoma (APA). Other forms of PA are less common, and include unilateral hyperplasia and rare familial aldosteronism type I, II and III. Recent data shows that patients with PA have a significantly higher rate of cardiovascular risk than patients with essential hypertension (EH) (Catena et al. 2008)....