11-Beta Dehydrogenase Type 2 Activity Is Not Reduced in Treatment Resistant Hypertension

作者：Ghazi Lama^*; Dudenbostel Tanja; El Hachem Maria; Siddiqui Mohammed; Lin Chee Paul; Oparil Suzanne; Calhoun David A

来源：American Journal of Hypertension, 2017, 30(5): 518-523.

DOI：10.1093/ajh/hpx002

• 11-beta dehydrogenase type 2
• blood pressure
• cortisol/cortisone ratio
• hypertension
• resistant hypertension

BACKGROUND AND OBJECTIVE
Decreased renal 11-beta dehydrogenase type 2 (11 beta-HSD2) activity, as reflected by an increased urinary free cortisol to cortisone ratio (UFF/UFE), is associated with having hypertension (HTN). The current study was conducted to determine if reduced 11 beta-HSD2 activity is also associated with having resistant HTN.
METHOD
We evaluated 55 consecutive patients with RHTN, defined as blood pressure (BP) >= 140/90 mm Hg despite using >= 3 antihypertensive medications including a diuretic, and 38 patients whose BP was controlled on <= 3 medications to serve as a non-RHTN comparator group. All patients underwent biochemical evaluation, including measurement of 24-hour urinary UFF/UFE.
RESULTS
The 2 study groups had similar demographic characteristics. Systolic, diastolic BP, and number of antihypertensive medications were greater in patients with uncontrolled RHTN vs. the control group (167.5 +/- 28.2/91.2 +/- 18.8 vs. 126.6 +/- 11.4/77.8 +/- 8.65 mm Hg and 4.31 +/- 1.23 vs. 2.74 +/- 0.6, respectively). The 24-hour UFF was 13.6 +/- 11.8 vs. 14.3 +/- 10.7 mu g/24 h and UFE was 64.9 +/- 36.3 vs. 76.1 +/- 44 mu g/24 h such that the UFF/UFE was 0.22 +/- 0.16 vs. 0.19 +/- 0.09 in RHTN vs. the control group. This ratio was not associated to age, race, gender, and body mass index.
CONCLUSION
An elevated UFF/UFE was not present in this large cohort of patients with uncontrolled RHTN. This suggests that reduced conversion of cortisol to cortisone does not contribute to the development of RHTN.

• 出版日期2017-5