Kobayashi Hiroki, Haketa Akira, Takahiro Ueno, Otsuka Hiromasa, Tanaka Sho, Hatanaka Yoshinari, Ikeda Yukihiro, Abe Masanori, Fukuda Noboru, Soma Masayoshi
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
J Clin Hypertens (Greenwich). 2017 Mar;19(3):280-286. doi: 10.1111/jch.12956. Epub 2016 Dec 5.
Although plasma aldosterone concentration (PAC) varies depending on primary aldosteronism (PA) subtypes, patients with different subtypes may have similar blood pressure (BP). The authors hypothesized that hormones other than aldosterone might influence BP in PA patients. A total of 73 PA cases, including 30 cases of aldosterone-producing adenomas (APAs), 29 cases of bilateral hyperaldosteronism, and 24 control cases of essential hypertension were enrolled retrospectively. The authors examined the levels of aldosterone, cortisol, renin, and adrenocorticotropic hormone (ACTH) measured at 12 am, 6 am, 12 pm, and 6 pm and BP in the early morning (6 am to 7 am), late morning (9 am to 11 am), and early evening (5 pm to 7 pm). Results showed no statistically significant correlation between PAC and BP in the patients with PA; however, early and late morning systolic BP strongly correlated with ACTH at 6 am in patients with APA. These results suggest that hormones other than aldosterone, such as ACTH, may affect BP in patients with APA.
尽管血浆醛固酮浓度（PAC）因原发性醛固酮增多症（PA）的亚型不同而有所变化，但不同亚型的患者可能具有相似的血压（BP）。作者推测，除醛固酮外的其他激素可能会影响PA患者的血压。回顾性纳入了73例PA病例，包括30例醛固酮瘤（APA）、29例双侧醛固酮增多症以及24例原发性高血压对照病例。作者检测了上午12点、上午6点、下午12点和下午6点时的醛固酮、皮质醇、肾素和促肾上腺皮质激素（ACTH）水平，以及清晨（上午6点至7点）、上午晚些时候（上午9点至11点）和傍晚（下午5点至7点）的血压。结果显示，PA患者的PAC与BP之间无统计学显著相关性；然而，APA患者上午早些时候和晚些时候的收缩压与上午6点时的ACTH密切相关。这些结果表明，除醛固酮外的其他激素，如ACTH，可能会影响APA患者的血压。
