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High plasma adrenomedullin concentrations in patients with high-renin essential hypertension

Department of Clinical Science, Chair of Internal Medicine, University of Rome "La Sapienza", Rome, Italy, claudio.letizia@ uniroma1.it

Stefano Subioli

Department of Clinical Science, Chair of Internal Medicine, University of Rome "La Sapienza", Rome, Italy

Sabrine Cerci

Department of Clinical Science, Chair of Internal Medicine, University of Rome "La Sapienza", Rome, Italy

Chiara Caliumi

Department of Clinical Science, Chair of Internal Medicine, University of Rome "La Sapienza", Rome, Italy

Cristiana Verrelli

Department of Clinical Science, Chair of Internal Medicine, University of Rome "La Sapienza", Rome, Italy

Enrica Delfini

Department of Clinical Science, Chair of Internal Medicine, University of Rome "La Sapienza", Rome, Italy

Massimiliano Celi

Department of Clinical Science, Chair of Internal Medicine, University of Rome "La Sapienza", Rome, Italy

Luigi Scuro

Department of Clinical Science, Chair of Internal Medicine, University of Rome "La Sapienza", Rome, Italy

Emilio D'Erasmo

Department of Clinical Science, Chair of Internal Medicine, University of Rome "La Sapienza", Rome, Italy

Adrenomedullin (AM) is a novel peptide, first isolated from human phaeochromocytoma, which elicits a long-lasting vasorelaxant activity. Recently, it has been reported that endothelial cells produce AM and that immunoreactive AM plasma levels may be elevated in human arterial hypertension, although the exact pathophysiological role of AM remains to be established.

The aim of our study was to determine the relationship between the components of the renin-angiotensin-aldosterone system (RAAS) and plasma AM levels in patients with low-, medium- or high-renin essential hypertension.

The study groups included 10 patients with low-renin essential hypertension (average age 42 15 years), nine patients with medium-renin essential hypertension (46 13 years), 11 patients with high-renin essential hypertension (42 14 years) and 12 healthy subjects (43 11 years).

Our results demonstrated that the mean AM values of all patients with essential hypertension were 10.85 3.14 pg/ml; there was a statistical correlation (r=0.705; p<0.001) between plasma renin activity (PRA) and AM levels in hypertensives.

In patients with high-renin essential hypertension, plasma AM levels (14.2 2.2 pg/ml) were significantly higher (p<0.001) than those of healthy subjects (8.7 2.1 pg/ml), patients with medium-renin essential hypertension (8.5 1.4 pg/ml), and patients with low-renin essential hypertension (9.1 1.5 pg/ml). There was no statistical difference in AM concentrations between medium- and low-renin hypertensive patients. In conclusion, we have found that, in hypertensive patients, plasma AM levels were increased only in high-renin individuals, suggesting a role of AM in this particular form of human essential hypertension.

Key Words: adrenomedullin • essential hypertension • renin-angiotensin-aldosterone system

Journal of Renin-Angiotensin-Aldosterone System, Vol. 3, No. 2, 126-129 (2002)
DOI: 10.3317/jraas.2002.014


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