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Relations between large artery structure and function and aldosterone

Safar, Michel E.a,b,c; Millasseau, Sandrined; Mahmud, Azrac; Blacher, Jacquesa,b,c

doi: 10.1097/HJH.0b013e328349adf6
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Aldosterone influences independently the vascular environment in humans, acting through structural and functional modifications of the arterial wall as derived from mineralocorticoid receptors. In rats, aldosterone infusion increases arterial stiffness in the presence of high-sodium intake, together with development of extracellular matrix and inflammatory factors. A selective increase in systolic and pulse pressure ensues, causing predominant organ damage on the heart, kidney and large arteries. In humans at rest, but independently of mean arterial pressure, arterial stiffness and wave reflections are associated with a steeper increase in these parameters with age. This finding is observed mainly with the CC genotype and not the TT or the TC genotype of the aldosterone synthase gene polymorphism. Early identification of individuals presenting this genotype could be important to detect hypertension.

aUniversité Paris Descartes

bAssistance Publique-Hôpitaux de Paris

cCentre de Diagnostic et de Thérapeutique, Hôtel-Dieu, Paris

dPulse Wave Consulting, Saint-Leu-la-Foret, France

cDepartment of Pharmacology and Therapeutics, Hypertension Clinic, Trinity College and St James's Hospital, Dublin, Ireland

Correspondence to Michel E. Safar, MD, Centre de Diagnostic et de Thérapeutique, Hôtel-Dieu 1, place du Parvis Notre-Dame, 75181 Paris Cedex 04, FranceTel: +33 1 4234 8025; fax: +33 1 4234 8632; e-mail: michel.safar@htd.aphp.fr

Abbreviations: ACE, angiotensin-converting enzyme; ASGP, aldosterone synthase gene polymorphism; BP, blood pressure; EFV, extracellular fluid volume; Einc, incremental elastic modulus; HR, heart rate; MCSA, medial cross-sectional area; PRA, plasma renin activity; PWV, pulse wave velocity; SHR, spontaneously hypertensive rat; VSM, vascular smooth muscle

Received 19 January, 2011

Revised 19 May, 2011

Accepted 8 June, 2011

© 2011 Lippincott Williams & Wilkins, Inc.