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[Functional activity of the adrenal glands and the hormone-protein interactions in patients with hypertension with a
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Essential hypertension and related conditions activate adrenal glucocorticoids, reducing transcortin binding capacity (TBC). Circulatory issues further impair adrenal function and TBC, indicating a failure of adaptation systems.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Hypertension Research
Background:
- Essential hypertension is linked to adrenal glucocorticoid activation.
- Coronary heart disease can complicate hypertension, affecting endocrine function.
- Transcortin binding capacity (TBC) plays a role in regulating cortisol levels.
Purpose of the Study:
- To investigate adrenal glucocorticoid function in patients with essential hypertension and coronary heart disease.
- To assess the impact of circulatory insufficiency on adrenal reserve and TBC.
- To explore the relationship between TBC, plasma protein levels, and adaptation to stress.
Main Methods:
- Assessed adrenal glucocorticoid activation in hypertensive patients.
- Measured transcortin binding capacity (TBC) in study participants.
- Evaluated functional adrenal reserve in patients with circulatory insufficiency (Stage I and IIB).
Main Results:
- Hypertension, especially with coronary heart disease, showed increased adrenal glucocorticoid activity and reduced TBC.
- Circulatory insufficiency led to decreased functional adrenal reserve and further TBC reduction.
- A correlation was observed between TBC and plasma protein levels.
- Stage IIB circulatory insufficiency sometimes showed decreased steroid protein affinity.
- Adrenal glands failed to respond to abrupt TBC drops, suggesting adaptation system failure.
Conclusions:
- Adrenal glucocorticoid activation and reduced TBC are characteristic of hypertension, particularly when complicated by coronary heart disease.
- Circulatory insufficiency exacerbates adrenal dysfunction and diminishes TBC, impacting the body's adaptive capacity.
- The findings suggest a complete failure of adaptation systems when adrenal function cannot compensate for significant drops in TBC.
Abstract:
Patients with essential hypertension and hypertension complicated by coronary heart disease showed adrenal glucocorticoid activation along with reduced transcortin binding capacity (TBC). The addition of circulatory insufficiency (stage I and IIB) resulted in a decrease of the functional adrenal reserve and further diminution of TBC due to a reduction of protein binding sites concentration, and sometimes (stage IIB) also a decrease in the protein affinity of steroids. A correlation between TBC and plasma protein level was found. The absence of adrenal functional response to an abrupt drop in TBC is interpreted as a complete failure of the adaptation systems.