Angiotensin II type 1 receptor messenger RNA levels in human blood cells of patients with primary and secondary hypertension: reference to renin profile.

OBJECTIVES

The relationship between plasma renin activity, plasma angiotensin II (Ang II) or aldosterone levels and peripheral blood cells (mononuclear leucocytes and platelets) Ang II type 1 (AT1) receptor messenger RNA (mRNA) levels were examined in both primary and secondary hypertensive patients.

DESIGN AND METHODS

The subjects were 30 patients with primary hypertension, five with primary aldosteronism, five with renovascular hypertension and five normotensive controls with renal cell carcinoma. Blood was collected from each patient for estimation of plasma renin activity and plasma Ang II and aldosterone concentrations, and for isolation of mononuclear leucocytes and platelets, which were then used to measure AT1 receptor mRNA with reverse-transcription polymerase chain reaction.

RESULTS

Platelet AT1 receptor mRNA levels were inversely correlated with plasma Ang II levels, and mononuclear leucocyte receptor mRNA levels were positively correlated with plasma Ang II levels in patients with primary hypertension. In contrast, in secondary hypertension both platelets and mononuclear leucocytes AT1 receptor mRNA, which were elevated, were reduced after removal of the adrenal tumour or correction of stenosis of the renal artery.

CONCLUSIONS

Platelet AT1 receptors, which were used to reflect physiologically important sites such as vascular smooth muscle, were shown to be regulated in a different manner from mononuclear leucocyte receptors. In patients with primary aldosteronism and renovascular hypertension the plasma aldosterone level was shown to be an important factor upregulating AT1 receptor mRNA.