High-circulating leptin levels are associated with increased blood pressure in uncontrolled resistant hypertension

• Published in: Journal of human hypertension Vol. 27; no. 4; pp. 225 - 230
• Main Authors: de Haro Moraes, C, Figueiredo, V N, de Faria, A P C, Barbaro, N R, Sabbatini, A R, Quinaglia, T, Ferreira-Melo, S E, Martins, L C, Demacq, C, Júnior, H M
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.04.2013; Nature Publishing Group
• Subjects: 692/699/2743/393; 692/699/75/243; Aged; Aldosterone; Aldosterone - blood; Antihypertensive Agents - therapeutic use; Biomarkers - blood; Blood pressure; Blood Pressure - drug effects; Blood Pressure Monitoring, Ambulatory; Body mass index; Drug Resistance; Epidemiology; Female; Genetic aspects; Health Administration; Heart Rate; Humans; Hypertension; Hypertension - blood; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - physiopathology; Leptin; Leptin - blood; Linear Models; Male; Medicine; Medicine & Public Health; Middle Aged; original-article; Physiological aspects; Plasma; Predictive Value of Tests; Public Health; Risk Factors; Sympathetic nerves; Treatment Failure; Up-Regulation; Brazil; resistant hypertension; leptin; aldosterone; obesity
• ISSN: 0950-9240; 1476-5527; 1476-5527
• DOI: 10.1038/jhh.2012.29

Leptin and aldosterone have been associated with the pathophysiological mechanisms of hypertension. However, despite studies showing the association of leptin with intima-media thickness, arterial distensibility and sympathetic nerve activation, the relationship between leptin and blood pressure (BP) in resistant hypertension (RHTN) is unknown. We aimed to assess the correlation of plasma leptin and aldosterone levels with BP in uncontrolled controlled RHTN (UCRHTN) and CRHTN patients. Plasma leptin and aldosterone levels, office BP, ambulatory BP monitoring and heart rate were measured in 41 UCRHTN, 39 CRHTN and 31 well-controlled HTN patients. No differences were observed between the three groups regarding gender, body mass index and age. The UCRHTN group had increased leptin when compared with CRHTN and well-controlled HTN patients (38.2±21.4, 19.6±8.7 and 20.94±13.9 ng ml −1 , respectively; P <0.05). Aldosterone levels values were also statistically different when comparing RHTN, CRHTN and well-controlled HTN patients (9.6±3.8, 8.1±5.0 and 8.0±4.7 ng dl −1 , respectively; P <0.05). As expected, UCRHTN patients had higher heart rate values compared with CRHTN and well-controlled HTN patients (86.2±7.2, 83.5±6.7 and 83.4±8.5, respectively; P <0.05). Plasma leptin positively correlated with systolic (SBP) and diastolic BP (DBP), and aldosterone ( r =0.43, 0.35 and 0.47, respectively; all P <0.05) in UCRHTN, but neither in the CRHTN nor in the HTN group. Simple linear regression showed that SBP, DBP and aldosterone may be predicted by leptin ( r 2 =0.16, 0.15 and 0.19, respectively; all P <0.05) only in the UCRHTN subgroup. In conclusion, UCRHTN patients have higher circulating leptin levels associated with increased plasma aldosterone and BP levels when compared with CRHTN and HTN subjects.