Urinary cortisol to cortisone metabolites ratio in prednisone-treated and spontaneously hypertensive patients
Anno:
2008
Tipologia prodotto:
Articolo in Rivista
Tipologia ANVUR:
Articolo su rivista
Lingua:
Inglese
Referee:
Sì
Nome rivista:
Journal of Hypertension
ISSN Rivista:
0263-6352
N° Volume:
26
Numero o Fascicolo:
3
Intervallo pagine:
486-493
Note:
OBJECTIVE AND METHODS: Prednisone and its active metabolite prednisolone, both substrates for 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2), may represent a pharmacological challenge for the enzyme. The aim of the present work was to define the possible role of abnormal cortisol/cortisone handling, as revealed by an urinary tetrahydrocortisol + allotetrahydrocortisol (THFs)/tetrahydrocortisone (THE) ratio between 1.5 and 3.0, by measuring urinary cortisol and cortisone metabolites in: normotensive individuals (n = 100) who received 7-8 mg/day of oral prednisone and were then followed for development of hypertension; essential hypertensive (EH) participants from primary care (n = 103); and EH hypertensive patients referred to the Hypertension Unit (n = 141). RESULTS: About one-third (14 out of 47, 30\%) of glucorticoid-treated patients who developed hypertension showed a THFs/THE ratio >1.5, which was seen in 3\% (n = 3) and 14\% (n = 19) of primary and tertiary care hypertensive patients, respectively. A THFs/THE ratio >1.5 was associated with a 3.8-fold incremental risk of hypertension after glucocorticoid therapy, regardless of duration and intensity of prednisone therapy. CONCLUSIONS: A number of EH patients and glucocorticoid-treated participants shared a similar phenotype, characterized by both arterial hypertension and elevated urinary THFs/THE ratio. Such a phenotype is more common in severely, rather than in mildly, hypertensive patients