Αλδοστερονισμός και βλάβη στα όργανα-στόχους σε ασθενείς με πρωτοπαθή υπέρταση

Doctoral Dissertation uoadl:1305600 248 Read counter

Unit:
Τομέας Παθολογίας
Library of the School of Health Sciences
Deposit date:
2014-03-14
Year:
2014
Author:
Τζάμου Βασιλική
Dissertation committee:
Γρηγόριος Π Βυσσούλης
Original Title:
Αλδοστερονισμός και βλάβη στα όργανα-στόχους σε ασθενείς με πρωτοπαθή υπέρταση
Languages:
Greek
Summary:
Introduction: Aldosterone is vied as a designer hormone in essential
hypertension. The objective of this study was to investigate the effect of
subclinical hyperaldosteronism in target organs in patients with primary,
uncomplicated hypertension.
Materials and Methods: The study included 1310 consecutive essential
hypertensive patients. Patients were evaluated with medical history, repeated
office blood pressure and 24-h ambulatory blood pressure monitoring, physical
examination and full laboratory assessment including ALDO in 24-h urine
collection, serum aldosterone (aldo) and plasma renin activity (PRA) measured
in morning blood samples. Patients with suspected primary or secondary
aldosteronism were excluded from the study. All patients were evaluated with
complete clinical and diagnostic assessment, which confirmed the presence of
primary hypertension.
Patients were divided according to PRA (high PRA >1ngml-1h-1, low PRA
<1ngml-1h-1) and ALDO levels (high ALDO >12 but <24 μg per 24 h, low ALDO <12
μg per 24 h) in four groups and according to PRA quartiles, ALDO quartiles,
aldo quartiles and aldo divided to PRA (ARR) quartiles.
In each patient was recorded ambulatory blood pressure monitoring to confirm
the hypertension, and then patients were grouped into extreme dippers, dippers,
non-dippers and reverse dippers. Subsequently, measurement was made to evaluate
the arterial stiffness according to pulse wave velocity and the reflected,
echocardiographic control for assessing the structure and function of the left
ventricle, 24-hour urine collection for the determination of aldosterone (ALDO
24), creatinine, microalbumin and a1 microglobulin. Also became a full
laboratory test for assessment of renal function and investigation of glucose
metabolism.
Results: In this study the markers related to the target organ damage were
positively associated with increased levels of aldosterone after adjustment
Conclusions: The main finding of this study is that in essential hypertensive
patients not receiving medication, the group of patients with a more activated
axis of RAAS appears to be more "aggravated".
Keywords:
Aldosteronism , Target organ damage, Essential hypertension , Renin Angiotensin Aldosterone System
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
181
Number of pages:
136

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