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Type: Artigo de periódico
Title: Leptin and Aldosterone in Sympathetic Activity in Resistant Hypertension with or without Type 2 Diabetes
Author: Boer-Martins, Leandro
Figueiredo, Valeria Nasser
Demacq, Caroline
Martins, Luiz Claudio
Cabral de Faria, Ana Paula
Moraes, Carolina de Haro
Moreno, Heitor, Jr.
Abstract: Background: The finding of adipocyte-derived hormone leptin as an overstimulator of sympathetic activity brought a new perspective to the pathophysiological mechanisms of obesity-hypertension. Objectives: As aldosterone also increases sympathetic activity, we aimed to assess the relationship between sympathetic overactivity and plasma leptin and aldosterone levels in resistant hypertension (RHTN), comparing the groups with and without T2D. Methods: Twenty-five RHTN patients underwent ambulatory electrocardiography to analyze heart rate variability (HRV) in time and frequency domains, which were stratified into two periods: 24 hours and daytime (DT), comprising the records between 2:00 p.m to 6:00 p.m (time domain) and one hour at 3:00 p.m (frequency domain). Results: T2D group (n=10) had higher serum aldosterone and plasma leptin levels than the non-T2D (n=15) (26.0 +/- 11.5 vs. 16.9 +/- 7.0 ng/dL - p=0.021; 81.368.7 +/- 47.086.1 vs 41.228.1 +/- 24.523.1 pg/mL - p=0.048, respectively). Both groups had aldosterone correlated with HRV in frequency domain. Non-T2D had aldosterone correlated with DT low frequency in normalized units (LF nu) (r=0.6 [0.12-0.85] p=0.018) and DT high frequency in normalized units (HF nu) (r=-0.6 [-0.85- -0.12] p=0.018). Type-2-diabetes group had aldosterone correlated with DT LF nu (r=0.72 [0.16-0.93] p=0.019) and DT HF nu (r=-0.72 [-0.93- -0.16] p=0.019). However, despite of the importance of leptin in sympathetic overactivity in hypertension, leptin did not correlate with HRV. Conclusion: Aldosterone seems to overdrive sympathetic activity in RHTN with and without T2D. This information combined with the clinical efficacy of mineralocorticoid receptor blocker in RHTN may reinforce that aldosterone is a major player to be a therapeutic target in RHTN. (Arq Bras Cardiol 2012; 99(1): 642-648)
Subject: Hypertension
sympathetic nervous system
diabetes mellitus
type 2
Country: Brazil
Editor: Arquivos Brasileiros Cardiologia
Citation: Arquivos Brasileiros de Cardiologia. Arquivos Brasileiros Cardiologia, v.99, n.1, p.642-648, 2012
Rights: aberto
Date Issue: 2012
Appears in Collections:FCM - Artigos e Outros Documentos

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