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Dudenbostel T, Li P, Calhoun DA. Paradoxical Increase of 24-Hour Urinary Aldosterone Levels in Obese Patients With Resistant Hypertension on a High Salt Diet. Am J Hypertens. 2021;34(6):600-608doi: 10.1093/ajh/hpaa208.
Dudenbostel, T., Li, P., & Calhoun, D. A. (2021). Paradoxical Increase of 24-Hour Urinary Aldosterone Levels in Obese Patients With Resistant Hypertension on a High Salt Diet. American journal of hypertension, 34(6), 600-608. https://doi.org/10.1093/ajh/hpaa208
Dudenbostel, Tanja, et al. "Paradoxical Increase of 24-Hour Urinary Aldosterone Levels in Obese Patients With Resistant Hypertension on a High Salt Diet." American journal of hypertension vol. 34,6 (2021): 600-608. doi: https://doi.org/10.1093/ajh/hpaa208
Dudenbostel T, Li P, Calhoun DA. Paradoxical Increase of 24-Hour Urinary Aldosterone Levels in Obese Patients With Resistant Hypertension on a High Salt Diet. Am J Hypertens. 2021 Jun 22;34(6):600-608. doi: 10.1093/ajh/hpaa208. PMID: 33290515.
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Am J Hypertens. 2021 Jun 22;34(6):600-608. doi: 10.1093/ajh/hpaa208.

Paradoxical Increase of 24-Hour Urinary Aldosterone Levels in Obese Patients With Resistant Hypertension on a High Salt Diet.

American journal of hypertension

Tanja Dudenbostel, Peng Li, David A Calhoun

Affiliations

  1. Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama, Birmingham, Alabama, USA.
  2. Department of Acute, Chronic & Continuing Care, School of Nursing, University of Alabama, Birmingham, Alabama, USA.

PMID: 33290515 DOI: 10.1093/ajh/hpaa208

Abstract

BACKGROUND: Having previously reported that aldosterone levels increase progressively with body mass index (BMI), the current analysis was done to determine to what extent this association is related to dietary high salt intake. We anticipated that aldosterone levels would decrease with higher sodium status consistent with classical suppression of aldosterone release secondary to progressive fluid retention induced by high dietary sodium intake.

METHODS: Cross-sectional analysis of a large diverse cohort of 2,705 patients with resistant hypertension (HTN) seen in a referral HTN Clinic. Dietary sodium intake was indexed by 24-hour (h) urinary sodium (UNa), aldosterone status was determined by plasma aldosterone concentration, plasma renin activity, and 24 h urinary aldosterone (UAldo). Patients with normal weight served as control.

RESULTS: In this study, 1,572 individuals with complete 24 h urine collections were analyzed. Mean BMI was 32.5 ± 7.1 kg/m2 and ranged from 24.6 ± 2.4 kg/m2 (first quartile) to 41.0 ± 4.2 kg/m2 (fourth quartile). BMI was positively associated with 24 h UNa and UAldo levels (P < 0.0001), 24 h UNa and UAldo. There was a positively stronger correlation in obese (r = 0.273, P < 0.0001) compared with normal weight individuals (r = 0.108, P = 0.0342) independent of number and classes of antihypertensive medications.

CONCLUSIONS: Our analysis shows that there is an altered regulation of aldosterone in obese patients in the setting of high dietary salt intake.

© American Journal of Hypertension, Ltd 2020. All rights reserved. For Permissions, please email: [email protected].

Keywords: adrenal; blood pressure; dysregulation; endocrine; hypertension; obesity

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