Abstract
Background: A possible role of vasopressin in the development of arterial hypertension in patients with hypercortisolism was investigated.
Methods: Four groups of subjects of both sexes were included. In all of them plasma vasopressin was determined. Twenty-four patients with Cushing’s disease (13 hypertensive and 11 still normotensive) were studied during the active period of the disease and after correction of hypercortisolism. A second group included 14 patients with Addison’s disease receiving specific hormone replacement. Thirty-two subjects with uncomplicated, untreated essential hypertension and a group of eight control healthy normotensive volunteers were also enrolled.
Results: Baseline vasopressin (pg/mL) was higher (p < 0.05) in hypertensive patients with Cushing’s disease (3.2 ± 0.63) compared with all groups: normotensive patients with Cushing’s disease (1.6 ± 0.75), patients with Addison’s disease (1.9 ± 0.29), essential hypertensive patients (1.4 ± 0.21) and control normotensive volunteers (1.4 ± 0.20). Treatment reduced plasma cortisol, mean arterial pressure (MAP) and vasopressin in patients with Cushing’s disease. On examining those patients in detail, only 13 had no relapse of the disease after surgical treatment, and vasopressin and MAP were significantly reduced only in the seven who were previously hypertensive.
Conclusions: Our data show that in normotensive patients with Cushing’s disease, plasma vasopressin is lower than in patients with hypertension. Moreover, after an effective surgical treatment, plasma vasopressin is lowered concurrently with lowering of MAP only in patients who were hypertensive. Patients with Addison’s disease receiving specific hormone replacement have low/normal plasma cortisol and normal vasopressin levels. Our observations suggest that vasopressin may have a role in the genesis or in development of hypertension associated with high levels of plasma cortisol.
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References
Kjaer A. Vasopressin as a neuroendocrine regulator of anterior pituitary hormone secretion. Acta Endocrinol 1993; 129(6): 489–96
Sugimoto T, Saito M, Mochizuki S, et al. Molecular cloning and functional expression of a cDNA encoding the human V1b vasopressin receptor. J Biol Chem 1994; 269(43): 27088–92
Keyzer Y. Cloning and characterization of the human V3 pituitary vasopressin receptor. FEBS Lett 1994; 356(2-3): 215–20
Saito M, Sugimoto T, Tahara A, et al. Molecular cloning and characterization of rat V1b vasopressin receptor: evidence for its expression in extrapituitary tissues. Biochem Biophys Res Commun 1995 Jul 26; 212(3): 751–7
Aguilera G, Rabadan-Diehl C. Regulation of vasopressin V1b receptors in the anterior pituitary gland of the rat. Exp Physiol 2000; 85Spec. No.: 19S–26S
Mohr E, Richter D. Vasopressin in the regulation of body functions. J Hypertens 1994; 12(4): 345–8
Biewenga WJ, Rijnberk A, Mol JA. Osmoregulation of systemic vasopressin release during long-term glucocorticoid excess: a study in dogs with hyperadrenocorticism. Acta Endocrinol 1991; 124: 583–8
Aubry RH, Nankin HR, Moses AM, et al. Measurement of the osmotic threshold for vasopressin release in human subjects and its modification by cortisol. J Clin Endocrinol 1965; 25: 1481–92
Knoepfelmacher M, Pradal MJ, Di Dio R, et al. Resistance to vasopressin action on the kidney in patients with Cushing’s disease. Eur J Endocrinol 1997; 137: 162–6
Grazzini E, Lodboerer AM, Perez-Martin A, et al. Molecular and functional characterization of V1b vasopressin receptor in rat adrenal medulla. Endocrinology 1996; 137(9): 3906–14
Fujio I, Kafait UM. Contribution of vasopressin in dexamethasone-induced hypertension in rats. Hypertension 1988; 11Suppl. 1: I42–6
Del Bo A, Sved AF, Reis DJ. Inhibitory influences from arterial baroreceptors on vasopressin release elicited by fastigial stimulation in rats. Circ Res 1984; 54: 248–53
Danese RD, Aron DC. Cushing’s syndrome and hypertension. Endocrinol Metab Clin North Am 1994; 23: 299–324
Whitworth JA, Brown MA, Kelly JJ, et al. Mechanisms of cortisol-induced hypertension in humans. Steroids 1995; 60: 76–80
Ulick S. Cortisol as mineralcorticoid. J Clin Endocrinol Metab 1996; 81: 1307–8
Montrella-Waybill M, Clore JN, Schoolwerth AC, et al. Evidence that high dose cortisol-induced Na+ retention in man is not mediated by the mineralcorticoid receptor. J Clin Endocrinol Metab 1991; 72: 1060–6
Williamson PM, Kelly JJ, Whitworth JA. Dose response relationships and mineralocorticoid activity in cortisol-induced hypertension in humans. J Hypertens 1996; 14(5): S37–41
Saruta T. Mechanism of glucocorticoid-induced hypertension. Hypertens Res 1996; 19: 1–8
Pirpiris M, Sudhir K, Yeung S, et al. Pressor responsiveness in corticosteroidinduced hypertension in humans. Hypertension 1992; 19: 567–74
Sato A, Suzuki H, Iwaita Y, et al. Potentiation of inositol trisphosphate production by dexamethasone. Hypertension 1992; 19(1): 109–15
Walker BR, Connacher AA, Webb DJ, et al. Glucocorticoid and blood pressure: a role for the cortisol/cortisone shuttle in the control of vascular tone in man. Clin Sci 1992; 83: 171–8
Whitworth JA, Williamson PM, Brown MA, et al. Hyperinsulinemia is not a cause of cortisol-induced hypertension. Am J Hypertens 1994; 7: 562–5
Del Bo A, Marabini M, Morganti A, et al. Regulation of vasopressin release in moderately severe essential hypertension. Clin Auton Res 1991; 1: 109–14
Padfield PL, Brown JJ, Lever AF, et al. Blood pressure in acute and chronic excess: studies of malignant hypertension and the syndrome of inappropriate antidiuretic hormone secretion. N Engl J Med 1981; 304: 1067–70
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Giuditta, M., Dall’Asta, C., Ambrosi, B. et al. Hypercortisolism and Arterial Hypertension. High Blood Press Cardiovasc Prev 13, 41–45 (2006). https://doi.org/10.2165/00151642-200613020-00001
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DOI: https://doi.org/10.2165/00151642-200613020-00001