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Ananda RA, Gwini S, Beilin LJ, Schlaich MP, Stowasser M, Young MJ, Adler B, Fuller PJ, Mori TA, Yang J. Relationship Between Renin, Aldosterone, Aldosterone-to-Renin Ratio and Arterial Stiffness and Left Ventricular Mass Index in Young Adults. Circulation 2024; 150:2019-2030. [PMID: 39351674 DOI: 10.1161/circulationaha.124.070039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 09/03/2024] [Indexed: 12/18/2024]
Abstract
BACKGROUND Primary aldosteronism, characterized by renin-independent aldosterone production, is associated with adverse cardiovascular remodeling and outcomes. Elevated cardiovascular risk is observed even in subclinical forms of primary aldosteronism according to studies conducted primarily in middle-aged and elderly populations. This study aimed to assess whether early changes in primary aldosteronism biomarkers during young adulthood are associated with arterial stiffness and left ventricular mass index (LVMI) before the onset of overt disease. METHODS The Raine Study is a longitudinal, population-based cohort study in Western Australia that enrolled women during pregnancy. We analyzed the data from the offspring of these women at 17 (2006-2009) and 27 (2016-2018) years of age. Participants with elevated high-sensitivity C-reactive protein (>10 mg/L) and female participants who were on oral contraception were excluded. Pulse wave velocity and aortic augmentation index were measured by SphygmoCor Pulse Wave System at both ages, and aortic distensibility and LVMI were measured by cardiac magnetic resonance imaging at 27 years. Multivariable linear regression was used to examine the relationship between plasma renin, aldosterone, or aldosterone-to-renin ratio and arterial stiffness and LVMI. Mediation analysis was used to test the role of systolic blood pressure. RESULTS This study included 859 participants at 17 (38.0% female) and 758 participants at 27 (33.2% female) years of age. Females had lower renin concentration at both 17 (20.7 mU/L versus 25.7 mU/L; P<0.001) and 27 (12.0 mU/L versus 15.4 mU/L; P<0.001) years of age; hence, the aldosterone-to-renin ratio was significantly higher at both 17 (18.2 versus 13.5; P<0.001) and 27 (21.0 versus 15.6; P<0.001) years of age in females compared with males. At 27 years of age, a significant association was detected between aldosterone and LVMI in males (β=0.009 [95% CI, 0.001-0.017]; P=0.027) and between aldosterone-to-renin ratio and LVMI in females (β=0.098 [95% CI, 0.001-0.196]; P=0.050) independently of systolic blood pressure and other confounders. No association was found between primary aldosteronism biomarkers and measures of arterial stiffness (pulse wave velocity, aortic augmentation index, and aortic distensibility) at either age. CONCLUSIONS Aldosterone concentration and aldosterone-to-renin ratio were positively associated with the LVMI in young males and females, respectively, independently of systolic blood pressure. Long-term follow-up is required to determine whether the relationship persists over time, and clinical trials are needed to assess the cardiovascular benefits of early interventions to block aldosterone.
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Affiliation(s)
- Roshan A Ananda
- Endocrine Hypertension Group, Centre of Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia (R.A.A., P.J.F., J.Y.)
| | - StellaMay Gwini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (S.G.)
| | - Lawrence J Beilin
- Medical School (L.J.B., T.A.M.), Royal Perth Hospital Unit, University of Western Australia, Australia
| | - Markus P Schlaich
- Dobney Hypertension Centre, Medical School (M.P.S.), Royal Perth Hospital Unit, University of Western Australia, Australia
| | - Michael Stowasser
- Endocrine Hypertension Research Centre, UQ Frazer Institute, Brisbane, Queensland, Australia (M.S.)
| | - Morag J Young
- Cardiovascular Endocrinology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (M.J.Y.)
- Department of Cardiovascular Health and Disease, Baker and University of Melbourne, Victoria, Australia (M.J.Y.)
| | - Brendan Adler
- Envision Medical Imaging, Perth, Western Australia, Australia (B.A.)
| | - Peter J Fuller
- Endocrine Hypertension Group, Centre of Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia (R.A.A., P.J.F., J.Y.)
| | - Trevor A Mori
- Medical School (L.J.B., T.A.M.), Royal Perth Hospital Unit, University of Western Australia, Australia
| | - Jun Yang
- Endocrine Hypertension Group, Centre of Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia (R.A.A., P.J.F., J.Y.)
- Department of Molecular and Translational Science (J.Y.), Monash University, Clayton, Victoria, Australia
- Department of Medicine (J.Y.), Monash University, Clayton, Victoria, Australia
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Sánchez-Delgado JC, Cohen DD, Camacho-López PA, Carreño-Robayo J, Castañeda-Hernández A, García-González D, Martínez-Bello D, Aroca-Martinez G, Parati G, Lopez-Jaramillo P. Handgrip Strength Is Associated with Specific Aspects of Vascular Function in Individuals with Metabolic Syndrome. Biomedicines 2023; 11:2435. [PMID: 37760876 PMCID: PMC10525985 DOI: 10.3390/biomedicines11092435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a disorder associated with an increased risk for the development of diabetes mellitus and its complications. Lower isometric handgrip strength (HGS) is associated with an increased risk of cardiometabolic diseases. However, the association between HGS and arterial stiffness parameters, which are considered the predictors of morbidity and mortality in individuals with MetS, is not well defined. OBJECTIVE To determine the association between HGS and HGS asymmetry on components of vascular function in adults with MetS. METHODS We measured handgrip strength normalized to bodyweight (HGS/kg), HGS asymmetry, body composition, blood glucose, lipid profile, blood pressure, pulse wave velocity (PWV), reflection coefficient (RC), augmentation index @75 bpm (AIx@75) and peripheral vascular resistance (PVR) in 55 adults with a diagnosis of MetS between 25 and 54 years old. RESULTS Mean age was 43.1 ± 7.0 years, 56.3% were females. HGS/kg was negatively correlated with AIx@75 (r = -0.440), p < 0.05, but these associations were not significant after adjusting for age and sex. However, when interaction effects between sex, HGS/kg and age were examined, we observed an inverse relationship between HGS/kg and AIx@75 in the older adults in the sample, whereas in the younger adults, a weak direct association was found. We also found a significant association between HGS asymmetry and PVR (beta = 30, 95% CI = 7.02; 54.2; p <0.012). CONCLUSIONS Our findings suggest that in people with MetS, maintaining muscle strength may have an increasingly important role in older age in the attenuation of age-related increases in AIx@75-a marker of vascular stiffness-and that a higher HGS asymmetry could be associated with a greater vascular resistance.
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Affiliation(s)
- Juan Carlos Sánchez-Delgado
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
- Grupo de Investigación Ser Cultura y Movimiento, Universidad Santo Tomás-Bucaramanga, Santander 680001, Colombia;
| | - Daniel D. Cohen
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, V94T9PX Limerick, Ireland
| | | | - Javier Carreño-Robayo
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Alvaro Castañeda-Hernández
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Daniel García-González
- Grupo de Investigación Ser Cultura y Movimiento, Universidad Santo Tomás-Bucaramanga, Santander 680001, Colombia;
| | - Daniel Martínez-Bello
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Gustavo Aroca-Martinez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080002, Colombia;
| | - Gianfranco Parati
- Istituto Auxologico Italuano & University of Milano-Bicocca, Department of Medicine and Surgery, Piazza Brescia, 20149 Milan, Italy
| | - Patricio Lopez-Jaramillo
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
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Ulgen C, Ozturk I, Sahin M, Guzel FB, Oguz A, Altunoren O, Gungor O. The amount of skeletal muscle mass is associated with arterial stiffness in hemodialysis patients. Ther Apher Dial 2023; 27:24-30. [PMID: 35426237 DOI: 10.1111/1744-9987.13853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/11/2022] [Accepted: 04/11/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Sarcopenia was determined to be associated with increased arterial stiffness in the nondialysis patient population, but there is no available data on this subject in dialysis patients. METHODS A total of 79 patients were included in the study. Sarcopenia was diagnosed according to the EWSGOP-2 criteria. Arterial stiffness was measured noninvasively with a mobile-O-Graph device. RESULTS Skeletal muscle mass was observed to be positively correlated with weight, body mass index, creatinine, and uric acid, while negatively correlated with augmentation index. There was a correlation between augmentation index and sodium, phosphorus, systolic blood pressure, diastolic blood pressure, cardiac index, muscle percentage, fat percentage, and skeletal muscle mass. When the determinants of augmentation index in the linear regression analysis were viewed, just the systolic blood pressure and skeletal muscle mass were observed to be the determinant. CONCLUSION Decreased skeletal muscle mass contributes to increased arterial stiffness in hemodialysis patients.
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Affiliation(s)
- Cansu Ulgen
- Internal Medicine Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Ilyas Ozturk
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Murat Sahin
- Endocrinology and Metabolism Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Fatma Betul Guzel
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Ayten Oguz
- Endocrinology and Metabolism Department, Biruni University Faculty of Medicine, Istanbul, Turkey
| | - Orcun Altunoren
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Ozkan Gungor
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
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Sarcopenia and cardiovascular disease in patients with and without kidney disease: what do we know? Int Urol Nephrol 2022; 55:1161-1171. [PMID: 36327007 DOI: 10.1007/s11255-022-03393-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
Cardiovascular disease (CVD) incidence is high in patients with chronic kidney disease (CKD) and is the most frequent cause of mortality in this population. Advanced age, hypertension, uremic toxins, endothelial dysfunction, atherosclerosis, hyperhomocysteinemia, oxidative stress, and inflammation are among the leading causes of increased CVD in advanced stages of CKD. Although defined as a decrease in muscle strength associated with aging, sarcopenia is also prevalent in CKD patients. Sarcopenia causes physical disability, low quality of life, and mortality. Regular exercise and nutritional supplementation may slow the progression of sarcopenia. Recent studies have shown that sarcopenia increases the risk of CVD and mortality in people with or without kidney disease. This review discusses the relationship between sarcopenia and CVD in light of the current literature.
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