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Endocrine Hypertension: Innovative Diagnostic and Therapeutic Approaches for the Clinical Practice

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 11010

Special Issue Editor

Dr. GianLuca Colussi

E-Mail Website
Guest Editor
Division of Clinical Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
Interests: secondary hypertension; pregnacy-related hypertension disorders; emergency medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Endocrine hypertension accounts for 10% of secondary causes of hypertension, and it can be diagnosed in about 1% of all patients affected by arterial hypertension. Endocrine hypertension consists mainly of primary aldosteronism, hypercortisolism, pheochromocytoma, hyperparathyroidism, and thyroid dysfunctions. In endocrine hypertension, several hormonal mechanisms have been demonstrated to influence factors involved in blood pressure regulation, and pathological mechanisms enhanced by hormonal excess have been associated with the exaggerated organ damage seen in this form of hypertension. Endocrine hypertension is often associated with other metabolic disorders such as diabetes and dyslipidemia, which contribute to increased cardiovascular risk. New developments in the field of genetic and molecular biology have improved our knowledge of the hormonal mechanisms and pathophysiological pathways involved in endocrine hypertension, allowing us to hypothesize future better-tailored approaches. This Special Issue will update information about diagnostic and therapeutic strategies for dealing with endocrine hypertension and its related organ damage.

Dr. Gian Luca Colussi
Guest Editor

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Keywords

  • hypertension
  • hormone
  • diabetes
  • dyslipidemia
  • endocrine
  • metabolism
  • cardiovascular
  • aldosterone
  • cortisol
  • insulin

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Published Papers (3 papers)

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Research

16 pages, 1614 KiB  
Article
Measurements of Plasma-Free Metanephrines by Immunoassay Versus Urinary Metanephrines and Catecholamines by Liquid Chromatography with Amperometric Detection for the Diagnosis of Pheochromocytoma/Paraganglioma
by Wolfgang Raber, Hans Kotal, Rodrig Marculescu, Christian Scheuba, Martin B. Niederle, Alexandra Kautzky-Willer and Michael Krebs
J. Clin. Med. 2020, 9(10), 3108; https://doi.org/10.3390/jcm9103108 - 26 Sep 2020
Cited by 4 | Viewed by 4596
Abstract
Studies conflict concerning the use of enzyme immunoassays (EIA) for plasma free metanephrines (P-MNs) vs. other methods for pheochromocytoma/paraganglioma (PPGL) diagnosis. We compared commercially available EIAs for P-MNs with high-pressure liquid chromatography (HPLC) for 24 h-urinary MNs (U-MNs) and -catecholamines (U-CATs). 943 (565 [...] Read more.
Studies conflict concerning the use of enzyme immunoassays (EIA) for plasma free metanephrines (P-MNs) vs. other methods for pheochromocytoma/paraganglioma (PPGL) diagnosis. We compared commercially available EIAs for P-MNs with high-pressure liquid chromatography (HPLC) for 24 h-urinary MNs (U-MNs) and -catecholamines (U-CATs). 943 (565 female, 378 male) patients (54 PPGL, 889 Non-PPGL) were studied. Simultaneous measurements of all parameters analyzed at the central lab of our university hospital was mandatory for inclusion. Sensitivity of P-MNs (94.4%) was similar to that of U-MNs (100%), and both were higher than of U-CATs (77.8%), specificity of P-MNs (100%) higher than of U-MNs (73.6%), and similar to U-CATs (99.8%). With the recently proposed downward adjusted ULN of P-MNs to correct for the reported negative bias of the EIAs sensitivity (98.1%) raised non-significantly, but specificity decreased significantly (94.8%). Areas under receiver-operating characteristic curves indicated comparable diagnostic performance of P-MNs (0.989) vs. U-MNs (0.995), both better than U-CATs (0.956). In summary, the EIAs to measure P-MNs performed similarly to U-MNs by HPLC, and both better than U-CATs by HPLC. The post-test probability of PPGL given a positive test result was best for P-MNs, and higher than for the other pairs of analytes. Downward corrections of ULN of P-MNs did not improve test performances. Full article
(This article belongs to the Special Issue Endocrine Hypertension: Innovative Diagnostic and Therapeutic Approaches for the Clinical Practice)
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8 pages, 1336 KiB  
Article
The Role of the CYP11B2 Promoter Polymorphism in the Diagnosis of Primary Aldosteronism
by Łukasz Żukowski, Natalia Wawrusiewicz-Kurylonek, Piotr Szumowski, Małgorzata Mojsak, Saeid Abdelrazek and Janusz Myśliwiec
J. Clin. Med. 2020, 9(5), 1519; https://doi.org/10.3390/jcm9051519 - 18 May 2020
Viewed by 2113
Abstract
Background: nowadays, primary aldosteronism (PA) is suggested to be the most frequent cause of secondary hypertension and it reaches 10% of whole hypertensive population. The CYP11B2 promoter polymorphism might cause aldosterone overproduction. The aim of this study was to establish whether the polymorphism [...] Read more.
Background: nowadays, primary aldosteronism (PA) is suggested to be the most frequent cause of secondary hypertension and it reaches 10% of whole hypertensive population. The CYP11B2 promoter polymorphism might cause aldosterone overproduction. The aim of this study was to establish whether the polymorphism CYP11B2 promoter has a significant impact on diagnostic of PA. Material and Methods: study group consisted of 239 hypertensive patients previously diagnosed with adrenal incidentaloma. For diagnose of PA were performed: screening test–aldosterone-renin ratio (ARR) and saline suppression test (SIT) as a confirmatory test. Genotyping was carried out by the real time PCR method. The significance of differences between the groups was evaluated through Student’s t-test. Results: our study revealed that genotype TT had plasma aldosterone concentration (PAC), ARR and SIT significantly higher in comparison with CC patients. The mean PAC in CC was 12.71 ng/dL vs. 20.55 ng/dL in TT patients (p = 0.037), which consequently gave a higher ARR in TT patients (119 vs. 44, p = 0.034). Mean aldosterone concentration in SIT was 2.40 ng/dL in CC patients and 9.99 ng/dL in TT patients (p = 0.046). Patients with CC genotype required less hypotensive drugs in comparison with TT genotype (p = 0.044). PA was recognized in 16 patients. Nine patients had TC genotype, six TT, and one with CC genotype. Conclusion: our study revealed predisposing TT genotype to PA. Additionally, patients with TT genotype, regardless of the PA presence, had more severe hypertension. The determination of the CYP11B2 promoter polymorphism seems to be useful in the diagnosis of PA, especially in cases where it is difficult to properly prepare patients for hormonal tests or even results of the hormonal test are incoherent. Full article
(This article belongs to the Special Issue Endocrine Hypertension: Innovative Diagnostic and Therapeutic Approaches for the Clinical Practice)
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8 pages, 601 KiB  
Article
Adrenal Vein Sampling to Distinguish Between Unilateral and Bilateral Primary Hyperaldosteronism: To ACTH Stimulate or Not?
by Tae-Yon Sung, Wilson Mawutor Alobuia, Monica Varun Tyagi, Chandrayee Ghosh and Electron Kebebew
J. Clin. Med. 2020, 9(5), 1447; https://doi.org/10.3390/jcm9051447 - 13 May 2020
Cited by 12 | Viewed by 3592
Abstract
The aim of this study is to determine the accuracy of adrenal vein sampling (AVS) with and without adrenocorticotropic hormone (ACTH) stimulation to distinguish between unilateral and bilateral primary hyperaldosteronism (PA). Retrospective analysis of a prospective database from a referral center between 1984 [...] Read more.
The aim of this study is to determine the accuracy of adrenal vein sampling (AVS) with and without adrenocorticotropic hormone (ACTH) stimulation to distinguish between unilateral and bilateral primary hyperaldosteronism (PA). Retrospective analysis of a prospective database from a referral center between 1984 and 2009, 76 patients had simultaneous cannulation of bilateral adrenal veins and AVS with and without ACTH stimulation. All patients had adrenalectomies. The selectivity index (SI, cut-off value ≥2) was used for confirmation of successful cannulation of the adrenal vein. The lateralization index (LI, cut-off value >2 and >4) was used for distinguishing between unilateral and bilateral PA. The SI ratio was higher with ACTH stimulation compared to without for the right adrenal vein (p = 0.027). The LI > 2 ratio was higher with ACTH stimulation compared to without (p = 0.007). For the LI > 4 ratio, there was no difference between with and without ACTH stimulation (p = 0.239). However, for a LI > 4, 7 patients (9.2%) were not lateralized with ACTH stimulation, but they did lateralize without ACTH stimulation. AVS with ACTH stimulation is associated with a higher SI ratio compared to AVS without ACTH stimulation. However, when using LI > 4 for AVS, samples without ACTH stimulation should also be included to detect a subset of patients with unilateral disease that are not detected with ACTH stimulation. Full article
(This article belongs to the Special Issue Endocrine Hypertension: Innovative Diagnostic and Therapeutic Approaches for the Clinical Practice)
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