Primary Hyperaldosteronism Clinical Trial
Official title:
Primary Hyperaldosteronism and Endothelial Ischemia-reperfusion Injury
Patients with primary hyperaldosteronism experience more cardiovascular events compared to
patients with primary hypertension, independent of the blood pressure level.
In this research we hypothesize that patients with primary hyperaldosteronism are more
susceptible to ischemia-reperfusion injury.
Patients with PHA have an increased risk of cardiovascular events, independent of blood pressure level. Also in patients suffering a myocardial infarction, circulating aldosterone levels are associated with increased mortality. In animal models of myocardial infarction, the administration of exogenous aldosterone increased infarct size, although other studies did not report this effect. In similar models, antagonists of the mineralocorticoid receptor (MR) reduced infarct size, which was completely abolished in ecto-5'-nucleotidase (CD73, the enzyme that catalyses extracellular formation of the endogenous nucleoside adenosine) and adenosine receptor knock-out mice. Therefore, we hypothesize that patients with PHA have an increased susceptibility for ischemia-reperfusion (IR)-injury due to down-regulation of the enzyme CD73. We will use the reduction in brachial flow-mediated dilation (FMD) by forearm IR as a well-validated endpoint for (endothelial) IR-injury. ;
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