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11ß-hydroxysteroid dehydrogenase type 2 activity is associated with left ventricular mass in essential hypertension

Glorioso, Nicola and Filigheddu, Fabiana and Pinna Parpaglia, Paolo and Soro, Aldo and Troffa, Chiara and Argiolas, Giuseppe and Mulatero, Paolo (2005) 11ß-hydroxysteroid dehydrogenase type 2 activity is associated with left ventricular mass in essential hypertension. European Heart Journal, Vol. 26 (5), p. 498-504. eISSN 1522-9645. Article.

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DOI: 10.1093/eurheartj/ehi070

Abstract

Aims: Left ventricular mass (LVM) is under the control of aldosterone and angiotensin II in experimental hypertension, but the effect of aldosterone on LVM is controversial in essential hypertension (EH). Some EH patients show a mild impairment of 11ß-hydroxysteroid dehydrogenase type 2 (11ß-HSD2) activity without clinical features of the syndrome of apparent mineralocorticoid excess, where the incomplete cortisol-to-cortisone conversion leads to glucocorticoid-mediated mineralocorticoid effects. The mineralocorticoid receptor and 11ß-HSD2 are co-expressed in human heart. We investigated whether LVM may be regulated by glucocorticoids in EH patients. Methods and results: The ratio between 24 h urinary tetrahydro derivatives of cortisol and cortisone (THFs/THE), plasma renin activity, 24 h urinary aldosterone, blood pressure, and LVM indexed for height2.7 (LVMh2.7) were analysed in 493 never-treated hypertensives and 98 normotensives. THFs/THE was associated with LVMh2.7 in hypertensives and normotensives (r=0.32, P<0.001, and r=0.17, P=0.04, respectively) and persisted after adjusting for confounders (multiple regression analysis). Body mass index, sex, recumbent plasma renin activity, and THFs/THE accounted for 26.1% of LVMh2.7 variation. Urinary aldosterone was not correlated with LVMh2.7. Conclusion: We suggest that glucocorticoids may take part in the regulation of LVM in EH patients as a function of 11ß-HSD2 activity, and contribute to the target organ damage associated with essential hypertension.

Item Type:Article
ID Code:271
Status:Published
Refereed:Yes
Uncontrolled Keywords:Cardiac mass, 11ß-hydroxysteroid dehydrogenase, mineralocorticoids, glucocorticoids, blood pressure
Subjects:Area 06 - Scienze mediche > MED/09 Medicina interna
Divisions:002 Altri enti e centri di ricerca del Nord Sardegna > Azienda ASL1, Sassari > Ospedale civile SS. Annunziata
001 Università di Sassari > 03 Istituti > Clinica medica generale e terapia medica
002 Altri enti e centri di ricerca del Nord Sardegna > Azienda ASL1, Sassari > Centro prevenzione, diagnosi e terapia dell'ipertensione arteriosa e delle complicanze cardiovascolari
Publisher:Oxford University Press
eISSN:1522-9645
Copyright Holders:© The European Society of Cardiology 2005
Additional Information:Pubblicato online il 15 dicembre 2004.
Deposited On:18 Aug 2009 10:01

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