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

Juan Carlos Yugar-Toledo; Lúcia Helena Bonalume Tácito; Sílvia Elaine Ferreira-Melo; Walnéia Sousa; Fernanda Consolin-Colombo; Maria Cláudia Irigoyen; Kléber Franchini; Otávio Rizzi Coelho; Heitor Moreno Jr

doi:10.1253/circj.69.1380

Clinical Investigation

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

Juan Carlos Yugar-Toledo, Lúcia Helena Bonalume Tácito, Sílvia Elaine Ferreira-Melo, Walnéia Sousa, Fernanda Consolin-Colombo, Maria Cláudia Irigoyen, Kléber Franchini, Otávio Rizzi Coelho, Heitor Moreno Jr

Author information

Juan Carlos Yugar-Toledo
Cardiovascular Pharmacology and Hypertension Section, Clinical Hospital of Campinas & Faculty of Medical Sciences, State University of Campinas (UNICAMP)
Lúcia Helena Bonalume Tácito
Cardiovascular Pharmacology and Hypertension Section, Clinical Hospital of Campinas & Faculty of Medical Sciences, State University of Campinas (UNICAMP)
Sílvia Elaine Ferreira-Melo
Cardiovascular Pharmacology and Hypertension Section, Clinical Hospital of Campinas & Faculty of Medical Sciences, State University of Campinas (UNICAMP)
Walnéia Sousa
Cardiovascular Pharmacology and Hypertension Section, Clinical Hospital of Campinas & Faculty of Medical Sciences, State University of Campinas (UNICAMP)
Fernanda Consolin-Colombo
Hypertension Unit, Heart Institute (InCor), University of Sao Paulo Medical School
Maria Cláudia Irigoyen
Hypertension Unit, Heart Institute (InCor), University of Sao Paulo Medical School
Kléber Franchini
Cardiovascular Pharmacology and Hypertension Section, Clinical Hospital of Campinas & Faculty of Medical Sciences, State University of Campinas (UNICAMP)
Otávio Rizzi Coelho
Cardiovascular Pharmacology and Hypertension Section, Clinical Hospital of Campinas & Faculty of Medical Sciences, State University of Campinas (UNICAMP)
Heitor Moreno Jr
Cardiovascular Pharmacology and Hypertension Section, Clinical Hospital of Campinas & Faculty of Medical Sciences, State University of Campinas (UNICAMP)

Keywords: Angiotensin II, Low-renin (volume-dependent) hypertension, Nitric oxide, Vascular reactivity

JOURNAL FREE ACCESS

2005 Volume 69 Issue 11 Pages 1380-1385

DOI https://doi.org/10.1253/circj.69.1380

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Abstract

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)

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