Elevación del cortisol urinario en hipertensos esenciales hiporreninémicos

Background: Glucocorticoids play a key role in blood pressure (BP) control and are associated with hypertension in patients with Cushing's syndrome. A number of reports indicate that cortisol (F) may be involved in etiology of essential hypertension (EH). F can bind to the mineralocorticoid rec...

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Autores principales:	Krall O,Paola, Mosso G,Lorena, Carvajal M,Cristián, Rojas O,Auristela, Fardella B,Carlos
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2004
Materias:	Aldosterone Glucocorticoids Hydrocortisone Hypertension Renin
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000900005
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spelling	oai:scielo:S0034-988720040009000052005-11-22Elevación del cortisol urinario en hipertensos esenciales hiporreninémicosKrall O,PaolaMosso G,LorenaCarvajal M,CristiánRojas O,AuristelaFardella B,Carlos Aldosterone Glucocorticoids Hydrocortisone Hypertension Renin Background: Glucocorticoids play a key role in blood pressure (BP) control and are associated with hypertension in patients with Cushing's syndrome. A number of reports indicate that cortisol (F) may be involved in etiology of essential hypertension (EH). F can bind to the mineralocorticoid receptor, triggering both sodium and water reabsorption in kidney, increase BP and cause renin suppression. Aim: To evaluate urinary free cortisol (UFF) excretion as a potential intermediate phenotype of essential hypertension and correlate F level with plasma renin activity (PRA) and serum aldosterone (SA). Patients and Methods: We recruited 132 EH patients and 16 normotensive healthy controls. Blood samples and 24 hours urine were collected for PRA, SA and UFF analysis. Differences in UFF excretion between sexes were normalized by urinary creatinine (Creat) excretion. The upper limit of UFF/Creat was determined in normotensives considering the mean value plus 2 standard deviations. According to this value, subjects were classified as having high or normal UFF. Results: In EH patients and in normotensives, the UFF/Creat was 36.9±17.0 µg/gr and 30.9±8.8 µg/gr, respectively. The upper limit was set at 48.5 µg/gr. A high UFF/Creat was found in 20/132 EH (15%) patients and 0/16 normotensive subjects. EH patients with high UFF showed lower PRA levels than patients with normal cortisol levels (0.78±0.47 vs. 1.13±0.66 ng/ml*h, respectively, p=0.027) and lower SA values (4.52±1.65 vs 6.34±3.37 ng/dl, respectively, p=0.018). There was a negative correlation between UFF and PRA (r=-0.176, p=0.044) and between UFF and SA (r=-0.183, p=0.036). Conclusions: We have identified a subgroup of EH patients with increased UFF excretion. Patients with the highest UFF showed lower renin and aldosterone levels. These data suggest a potential influence of cortisol in the genesis of hypertension (Rev Méd Chile 2004; 132: 1053-9)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.132 n.9 20042004-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000900005es10.4067/S0034-98872004000900005
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Aldosterone Glucocorticoids Hydrocortisone Hypertension Renin
spellingShingle	Aldosterone Glucocorticoids Hydrocortisone Hypertension Renin Krall O,Paola Mosso G,Lorena Carvajal M,Cristián Rojas O,Auristela Fardella B,Carlos Elevación del cortisol urinario en hipertensos esenciales hiporreninémicos
description	Background: Glucocorticoids play a key role in blood pressure (BP) control and are associated with hypertension in patients with Cushing's syndrome. A number of reports indicate that cortisol (F) may be involved in etiology of essential hypertension (EH). F can bind to the mineralocorticoid receptor, triggering both sodium and water reabsorption in kidney, increase BP and cause renin suppression. Aim: To evaluate urinary free cortisol (UFF) excretion as a potential intermediate phenotype of essential hypertension and correlate F level with plasma renin activity (PRA) and serum aldosterone (SA). Patients and Methods: We recruited 132 EH patients and 16 normotensive healthy controls. Blood samples and 24 hours urine were collected for PRA, SA and UFF analysis. Differences in UFF excretion between sexes were normalized by urinary creatinine (Creat) excretion. The upper limit of UFF/Creat was determined in normotensives considering the mean value plus 2 standard deviations. According to this value, subjects were classified as having high or normal UFF. Results: In EH patients and in normotensives, the UFF/Creat was 36.9±17.0 µg/gr and 30.9±8.8 µg/gr, respectively. The upper limit was set at 48.5 µg/gr. A high UFF/Creat was found in 20/132 EH (15%) patients and 0/16 normotensive subjects. EH patients with high UFF showed lower PRA levels than patients with normal cortisol levels (0.78±0.47 vs. 1.13±0.66 ng/ml*h, respectively, p=0.027) and lower SA values (4.52±1.65 vs 6.34±3.37 ng/dl, respectively, p=0.018). There was a negative correlation between UFF and PRA (r=-0.176, p=0.044) and between UFF and SA (r=-0.183, p=0.036). Conclusions: We have identified a subgroup of EH patients with increased UFF excretion. Patients with the highest UFF showed lower renin and aldosterone levels. These data suggest a potential influence of cortisol in the genesis of hypertension (Rev Méd Chile 2004; 132: 1053-9)
author	Krall O,Paola Mosso G,Lorena Carvajal M,Cristián Rojas O,Auristela Fardella B,Carlos
author_facet	Krall O,Paola Mosso G,Lorena Carvajal M,Cristián Rojas O,Auristela Fardella B,Carlos
author_sort	Krall O,Paola
title	Elevación del cortisol urinario en hipertensos esenciales hiporreninémicos
title_short	Elevación del cortisol urinario en hipertensos esenciales hiporreninémicos
title_full	Elevación del cortisol urinario en hipertensos esenciales hiporreninémicos
title_fullStr	Elevación del cortisol urinario en hipertensos esenciales hiporreninémicos
title_full_unstemmed	Elevación del cortisol urinario en hipertensos esenciales hiporreninémicos
title_sort	elevación del cortisol urinario en hipertensos esenciales hiporreninémicos
publisher	Sociedad Médica de Santiago
publishDate	2004
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000900005
work_keys_str_mv	AT krallopaola elevaciondelcortisolurinarioenhipertensosesencialeshiporreninemicos AT mossoglorena elevaciondelcortisolurinarioenhipertensosesencialeshiporreninemicos AT carvajalmcristian elevaciondelcortisolurinarioenhipertensosesencialeshiporreninemicos AT rojasoauristela elevaciondelcortisolurinarioenhipertensosesencialeshiporreninemicos AT fardellabcarlos elevaciondelcortisolurinarioenhipertensosesencialeshiporreninemicos
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Elevación del cortisol urinario en hipertensos esenciales hiporreninémicos

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