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Mildly raised corticosterone excretion rates in patients with essential hypertension
1Medical Research Council Blood Pressure Unit, Western Infirmary, Glasgow, UK.
Insights
Patients with untreated hypertension showed higher excretion of corticosterone metabolites (THB, alloTHB, THA), suggesting increased corticosterone secretion. This small increase may contribute to blood pressure regulation, especially with deficient 11 beta-hydroxysteroid dehydrogenase activity.
Area of Science:
- Endocrinology
- Hypertension Research
- Steroid Metabolism
Background:
- Untreated hypertension is a significant cardiovascular risk factor.
- Corticosterone is a steroid hormone with potential, albeit low, glucocorticoid and mineralocorticoid activity.
- Previous research has not fully elucidated the role of corticosterone in the pathophysiology of hypertension.
Purpose of the Study:
- To investigate corticosterone secretion rates in patients with untreated hypertension compared to normotensive controls.
- To explore the potential contribution of altered corticosterone metabolism to blood pressure regulation.
Main Methods:
- Quantification of urinary tetrahydrocorticosterone (THB), allotetrahydrocorticosterone (alloTHB), and tetrahydro-11-dehydrocorticosterone (THA) metabolites via mass spectrometry.
- Comparison of metabolite excretion rates between a large cohort of untreated hypertensive patients and matched normotensive individuals.
- Estimation of corticosterone secretion rate using the sum of measured urinary metabolites.
Main Results:
- Significantly higher excretion rates of THB, alloTHB, and THA were observed in hypertensive patients compared to controls.
- The sum of these metabolites indicated a higher estimated corticosterone secretion rate in the hypertensive group.
- Despite the increase, all measured excretion rates remained within the normal physiological range.
Conclusions:
- Elevated urinary metabolites suggest a modest increase in corticosterone secretion in untreated hypertension.
- The clinical significance of this finding is uncertain due to corticosterone's low potency.
- This increase, particularly in conjunction with mild 11 beta-hydroxysteroid dehydrogenase deficiency, warrants further investigation for its role in blood pressure regulation.
Abstract:
In a large group of patients with untreated hypertension, excretion rates of tetrahydrocorticosterone (THB), allotetrahydrocorticosterone (alloTHB) and tetrahydro-11-dehydrocorticosterone (THA) were all significantly higher than in a group of matched normotensive controls. Using the sum of these metabolites as an index of corticosterone secretion rate suggests that this variable is also higher. The increase was small (all excretion rates remained within the normal range) and corticosterone has low glucocorticoid and mineralocorticoid potency calling the clinical significance of this finding into question. However, it is possible that in combination with mildly deficient 11 beta-hydroxysteroid dehydrogenase activity such increases in corticosterone levels might affect blood pressure.