Low-Renin (Volume Dependent) Mild-Hypertensive Patients Have Impaired Flow-Mediated and Glyceryl-Trinitrate Stimulated Vascular Reactivity

• Published in: Circulation Journal Vol. 69; no. 11; pp. 1380 - 1385
• Main Authors: Yugar-Toledo, Juan Carlos, Tácito, Lúcia Helena Bonalume, Ferreira-Melo, Sílvia Elaine, Sousa, Walnéia, Consolin-Colombo, Fernanda, Irigoyen, Maria Cláudia, Franchini, Kléber, Coelho, Otávio Rizzi, Moreno, Heitor, Jr
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2005
• Subjects: Adult; Angiotensin II; Brachial Artery - pathology; Brachial Artery - physiopathology; Carotid Artery, Common - pathology; Carotid Artery, Common - physiopathology; Case-Control Studies; Female; Humans; Hypertension - blood; Hypertension - pathology; Hypertension - physiopathology; Low-renin (volume-dependent) hypertension; Male; Middle Aged; Nitric oxide; Nitroglycerin - administration & dosage; Renin - blood; Tunica Intima - pathology; Tunica Intima - physiopathology; Vascular reactivity; Vasodilation - drug effects; Vasodilator Agents - administration & dosage
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.69.1380

Background Low-renin (volume-dependent) hypertension represents 25-30% of all cases of primary hypertension. Endothelial dysfunction and vascular remodeling are associated with hypertension but their relevance to volume-dependent hypertension (VDH) is not yet known. To evaluate this, flow-mediated dilation (FMD) of the brachial artery and the carotid intima-media thickness in the distal common carotid artery were measured and compared between renin-dependent mild-hypertensive patients (RDH) and controls. Method and Results The study group comprised 40 mild-hypertensive patients and 25 controls. Plasma renin activity (PRA), plasma aldosterone concentration, angiotensin II and nitrite/nitrate plasma levels were measured. According to PRA, subjects were classified as VDH (<0.6 ng · ml -1 · h-1), or RDH (>0.6 ng · ml-1 · h -1). Vascular function was evaluated by FMD before and after reactive hyperemia (RH) and glyceryl-trinitrate (GTN) administration. FMD in response to RH and GTN in the VDH group when compared with RDH group was 10.2±2.8% vs 13.3±3.6% (p=0.01); and 16.0±3.5% vs 19.9±4.5% (p=0.01), respectively. Conclusion This study showed impaired FMD and reduced GTN response in mildly hypertensive patients with low-renin plasma levels. (Circ J 2005; 69: 1380 -1385)