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High plasma adrenomedullin concentrations in patients with high-renin essential hypertension
Claudio Letizia
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
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Journal of Renin-Angiotensin-Aldosterone System, Vol. 3, No. 2,
126-129 (2002)
DOI: 10.3317/jraas.2002.014

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