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Impact of Endocrine Disorders on Blood Pressure

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Endocrinology and Systemic Diseases

Part of the book series: Endocrinology ((ENDOCR))

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Abstract

Endocrine hormones contribute to the vascular tone in physiological conditions. A complex interplay between different endocrine axes orchestrates a wide range of mediators involved in blood pressure (BP) control. Endocrine disorders may then lead to a pathological rise in blood pressure, also known as secondary hypertension. Their identification may improve BP control or even properly resolve the disease, finally reducing the global cardiovascular risk burden. In addition, experimental evidence from endocrine disorders provided interesting insights about the pathophysiology of primary hypertension. In this regard, both diabetes and the calcium-/phosphate-regulating hormones are not only considered a main cause of endocrine hypertension but also key players in development of primary hypertension. The same pathophysiological mechanisms implicated in primary hypertension are also dysregulated in case of secondary hypertension due to endocrine disorders involving thyroid hormones, mineral- and glucocorticoids, growth hormone/insulin-like growth, and sexual hormones. Therefore, secondary hypertension may represent a paradigm for understanding pathophysiological mechanism underlying the control of BP and should be considered a source to identify potential biomarkers and even therapeutic target. Here, we summarize the current knowledge linking endocrine system and the development of hypertension. Direct effects of insulin, thyroid hormones, mineral- and glucocorticoids, growth hormone/insulin-like growth factor, sexual hormones, and calcium-/phosphorus-regulating hormones will be analyzed, also considering the complex interplay between those different pathways. Both clinical evidence and interventional clinical trials will be discussed also describing the potential clinical implications.

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References

  • Adler AI, Stratton IM, Neil HA, Yudkin JS, Matthews DR, Cull CA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ. 2000;321:412–9.

    Article  CAS  Google Scholar 

  • American Diabetes Association. 9. Cardiovascular disease and risk management. Diabetes Care. 2017;40:S75–87.

    Google Scholar 

  • Balakumar P, Maung UK, Jagadeesh G. Prevalence and prevention of cardiovascular disease and diabetes mellitus. Pharmacol Res. 2016;113:600–9.

    Article  Google Scholar 

  • Bleicken B, Hahner S, Ventz M, Quinkler M. Delayed diagnosis of adrenal insufficiency is common: a cross-sectional study in 216 patients. Am J Med Sci. 2010;339:525–31.

    Article  Google Scholar 

  • Bornstein SR. Predisposing factors for adrenal insufficiency. N Engl J Med. 2009;360:2328–39.

    Article  CAS  Google Scholar 

  • Buleishvili M, Lobjanidze N, Ormotsadze G, Enukidze M, Machavariani M, Sanikidze T. Estrogen related mechanisms of hypertension in menopausal women. Georgian Med News. 2016;45–51.

    Google Scholar 

  • Carbone F, Mach F, Vuilleumier N, Montecucco F. Potential pathophysiological role for the vitamin D deficiency in essential hypertension. World J Cardiol. 2014;6:260–76.

    Article  Google Scholar 

  • Corona G, Giagulli VA, Maseroli E, Vignozzi L, Aversa A, Zitzmann M, et al. Testosterone supplementation and body composition: results from a meta-analysis of observational studies. J Endocrinol Investig. 2016;39:967–81.

    Article  CAS  Google Scholar 

  • Curb JD, Pressel SL, Cutler JA, Savage PJ, Applegate WB, Black H, et al. Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. Systolic Hypertension in the Elderly Program Cooperative Research Group. JAMA. 1996;276:1886–92.

    Article  CAS  Google Scholar 

  • Estacio RO, Jeffers BW, Hiatt WR, Biggerstaff SL, Gifford N, Schrier RW. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med. 1998;338:645–52.

    Article  CAS  Google Scholar 

  • Fedrizzi D, Rodrigues TC, Costenaro F, Scalco R, Czepielewski MA. Hypertension-related factors in patients with active and inactive acromegaly. Arq Bras Endocrinol Metabol. 2011;55:468–74.

    Article  Google Scholar 

  • Ferrannini E, Cushman WC. Diabetes and hypertension: the bad companions. Lancet. 2012;380:601–10.

    Article  Google Scholar 

  • Funder JW. Minireview: aldosterone and the cardiovascular system: genomic and nongenomic effects. Endocrinology. 2006;147:5564–7.

    Article  CAS  Google Scholar 

  • Geller DS, Farhi A, Pinkerton N, Fradley M, Moritz M, Spitzer A, et al. Activating mineralocorticoid receptor mutation in hypertension exacerbated by pregnancy. Science. 2000;289:119–23.

    Article  CAS  Google Scholar 

  • Hansson L, Zanchetti A, Carruthers SG, Dahlof B, Elmfeldt D, Julius S, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet. 1998;351:1755–62.

    Article  CAS  Google Scholar 

  • International Diabetes Federation (IDF). Global guideline for type 2 diabetes. 2012. URL: http://www.idf.org/sites/default/files/IDF-Guideline-for-Type-2-Diabetes.pdf. [Online] [Accessed].

  • James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–20.

    Article  CAS  Google Scholar 

  • Leung AA, Nerenberg K, Daskalopoulou SS, McBrien K, Zarnke KB, Dasgupta K, et al. Hypertension Canada’s 2016 Canadian hypertension education program guidelines for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol. 2016;32:569–88.

    Article  Google Scholar 

  • Mancia G, Grassi G. Aggressive blood pressure lowering is dangerous: the J-curve: pro side of the argument. Hypertension. 2014;63:29–36.

    Article  CAS  Google Scholar 

  • Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31:1281–357.

    Article  CAS  Google Scholar 

  • Mazza A, Beltramello G, Armigliato M, Montemurro D, Zorzan S, Zuin M, et al. Arterial hypertension and thyroid disorders: what is important to know in clinical practice? Ann Endocrinol. 2011;72:296–303.

    Article  CAS  Google Scholar 

  • Melcescu E, Phillips J, Moll G, Subauste JS, Koch CA. 11Beta-hydroxylase deficiency and other syndromes of mineralocorticoid excess as a rare cause of endocrine hypertension. Horm Metab Res. 2012;44:867–78.

    Article  CAS  Google Scholar 

  • Mihailidou AS, Loan Le TY, Mardini M, Funder JW. Glucocorticoids activate cardiac mineralocorticoid receptors during experimental myocardial infarction. Hypertension. 2009;54:1306–12.

    Article  CAS  Google Scholar 

  • National Institute for Health and Care Excellence (NICE). Hypertension in adults: diagnosis and management. 2011. nice.org.uk/guidance/cg127. Last updated Nov 2016.

  • Patel A, Group AC, MacMahon S, Chalmers J, Neal B, Woodward M, et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet. 2007;370:829–40.

    Article  CAS  Google Scholar 

  • Pilz S, Kienreich K, Drechsler C, Ritz E, Fahrleitner-Pammer A, Gaksch M, et al. Hyperparathyroidism in patients with primary aldosteronism: cross-sectional and interventional data from the GECOH study. J Clin Endocrinol Metab. 2012;97:E75–9.

    Article  CAS  Google Scholar 

  • Prisant LM, Gujral JS, Mulloy AL. Hyperthyroidism: a secondary cause of isolated systolic hypertension. J Clin Hypertens (Greenwich). 2006;8:596–9.

    Article  Google Scholar 

  • Sahakitrungruang T. Clinical and molecular review of atypical congenital adrenal hyperplasia. Ann Pediatr Endocrinol Metab. 2015;20:1–7.

    Article  Google Scholar 

  • Schrier RW, Estacio RO, Esler A, Mehler P. Effects of aggressive blood pressure control in normotensive type 2 diabetic patients on albuminuria, retinopathy and strokes. Kidney Int. 2002;61:1086–97.

    Article  Google Scholar 

  • Tuomilehto J, Rastenyte D, Birkenhager WH, Thijs L, Antikainen R, Bulpitt CJ, et al. Effects of calcium-channel blockade in older patients with diabetes and systolic hypertension. Systolic Hypertension in Europe Trial Investigators. N Engl J Med. 1999;340:677–84.

    Article  CAS  Google Scholar 

  • UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13.

    Article  Google Scholar 

  • Vecchione C, Colella S, Fratta L, Gentile MT, Selvetella G, Frati G, et al. Impaired insulin-like growth factor I vasorelaxant effects in hypertension. Hypertension. 2001;37:1480–5.

    Article  CAS  Google Scholar 

  • Verhelst J, Abs R. Cardiovascular risk factors in hypopituitary GH-deficient adults. Eur J Endocrinol. 2009;161(Suppl 1):S41–9.

    Article  CAS  Google Scholar 

  • Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014;16:14–26.

    Article  Google Scholar 

  • Wilczynski C, Shah L, Emanuele MA, Emanuele N, Mazhari A. Selective hypoaldosteronism: a review. Endocr Pract. 2015;21:957–65.

    Article  Google Scholar 

  • Xiang GD, Pu JH, Sun HL, Zhao LS. Alpha-lipoic acid improves endothelial dysfunction in patients with subclinical hypothyroidism. Exp Clin Endocrinol Diabetes. 2010;118(9):625–9.

    Google Scholar 

  • Yoon HE, Ghee JY, Piao S, Song JH, Han DH, Kim S, et al. Angiotensin II blockade upregulates the expression of Klotho, the anti-ageing gene, in an experimental model of chronic cyclosporine nephropathy. Nephrol Dial Transplant. 2011;26:800–13.

    Article  CAS  Google Scholar 

  • Zennaro MC, Lombes M. Mineralocorticoid resistance. Trends Endocrinol Metab. 2004;15:264–70.

    Article  CAS  Google Scholar 

  • Zennaro MC, Boulkroun S, Fernandes-Rosa F. An update on novel mechanisms of primary aldosteronism. J Endocrinol. 2015;224:R63–77.

    Article  CAS  Google Scholar 

  • Zimmet P, Alberti KG, Magliano DJ, Bennett PH. Diabetes mellitus statistics on prevalence and mortality: facts and fallacies. Nat Rev Endocrinol. 2016;12:616–22.

    Article  Google Scholar 

Download references

Acknowledgments

This study has been supported by a grant from the Rete Cardiologica of Italian Ministry of Health to Prof. F. Montecucco.

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Authors and Affiliations

  1. First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy

    Federico Carbone, Aldo Bonaventura, Luca Liberale, Alessandra Vecchiè, Matteo Casula & Franco Dallegri

  2. Ospedale Policlinico San Martino, Genoa, Italy

    Franco Dallegri & Fabrizio Montecucco

  3. First Clinic of Internal Medicine and Centre of Excellence for Biomedical Research (CEBR), Department of Internal Medicine, University of Genoa, Genoa, Italy

    Fabrizio Montecucco

  4. IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Nework, Genoa, Italy

    Fabrizio Montecucco

Authors
  1. Federico Carbone
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  2. Aldo Bonaventura
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  3. Luca Liberale
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  4. Alessandra Vecchiè
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  5. Matteo Casula
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  6. Franco Dallegri
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  7. Fabrizio Montecucco
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Corresponding author

Correspondence to Fabrizio Montecucco .

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Editors and Affiliations

  1. Dept of Biomed Sci & Human Oncology, Aldo Moro University Medical Sch Dept of Biomed Sci & Human Oncology, Bari, Italy

    Piero Portincasa

  2. Department of Endocrinology, Clinica Universidad de Navarra Department of Endocrinology, Pamplona, Spain

    Gema Frühbeck

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Carbone, F. et al. (2019). Impact of Endocrine Disorders on Blood Pressure. In: Portincasa, P., Frühbeck, G. (eds) Endocrinology and Systemic Diseases. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-66362-3_2-1

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  • DOI: https://doi.org/10.1007/978-3-319-66362-3_2-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66362-3

  • Online ISBN: 978-3-319-66362-3

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