Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Preferential association of aldosterone synthase gene polymorphism with central blood pressure and wave reflections in hypertensive individuals

Abstract

In hypertensive humans, the CC genotype of the aldosterone synthase gene polymorphism (ASGP) CYP11B2 (C-344T variant) is associated with increased aortic stiffness. Whether ASGP is also associated with altered central (carotid) wave reflections has never been investigated. After 1-month wash-out period, 124 hypertensive individuals were submitted to measurements of brachial and carotid systolic blood pressure (SBP), aortic pulse wave velocity (PWV) and wave reflections, using the carotid augmentation index (CAI) determined from pulse wave analysis. Two age- and sex-adjusted models of the impact of ASGP were analysed. Comparing the ASGP-CC with ASGP-TT and -TC genotypes, the former had significantly stronger intergroup correlation coefficients for age or CAI vs heart rate relationships (P=0.008; P=0.02). Stepwise multiple regressions showed that carotid SBP was independently influenced by PWV and CAI, but only in individuals with the CC (P=0.0002; P=0.03) and TC genotypes (P=0.0004; P=0.004). Those associations were not, or only weakly, observed using the brachial artery SBP model. In conclusion, this study showed that, in hypertensive individuals, ASGP is not directly associated with the SBP level, but rather independently with its two main determinants, central PWV and wave reflections. The result was observed only for CC and TC genotypes. Such findings are observed when central, but not brachial, haemodynamic measurements are performed.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Safar ME, O'Rourke MF (eds). Arterial stiffness in hypertension. In: Handbook of Hypertension. Elsevier: Edinburgh, 2006, pp 3–62, 75–136, 459–501.

    Google Scholar 

  2. Safar ME, Lajemi M, Rudnichi A, Asmar R, Benetos A . Angiotensin-converting enzyme D/I gene polymorphism and age-related changes in pulse pressure in subjects with hypertension. Arterioscler Thromb Vasc Biol 2004; 24: 782–786.

    Article  CAS  Google Scholar 

  3. Safar ME, Cattan V, Lacolley P, Nzietchueng R, Labat C, Lajemi M et al. Aldosterone synthase gene polymorphism, stroke volume and age-related changes in aortic pulse wave velocity in subjects with hypertension. J Hypertens 2005; 23: 1159–1166.

    Article  CAS  Google Scholar 

  4. Sookoian S, Gianotti TF, Gonzalez CD, Pirola CJ . Association of the C-344T aldosterone synthase gene variant with essential hypertension: a meta-analysis. J Hypertens 2007; 25: 5–13.

    Article  CAS  Google Scholar 

  5. Staessen JA, Li Y, Thijs L . Meta-analysis of blood pressure and the CYP11B2 polymorphism highlights the need for better designed studies. J Hypertens 2007; 25: 37–39.

    Article  CAS  Google Scholar 

  6. Casiglia E, Tikhonoff V, Mazza A, Rynkiewicz A, Limon J, Caffi S et al. C-344T polymorphism of the aldosterone synthase gene and blood pressure in the elderly: a population-based study. J Hypertens 2005; 23: 1991–1996.

    Article  CAS  Google Scholar 

  7. Newton-Cheh C, Guo CY, Gona P, Larson MG, Benjamin EJ, Wang TJ et al. Clinical and genetic correlates of aldosterone-to-renin ratio and relations to blood pressure in a community sample. Hypertension 2007; 49: 846–856.

    Article  CAS  Google Scholar 

  8. Nichols WW, O'Rourke M (eds). Theoretical, experimental and clinical principles. In McDonald's blood flow in arteries, 4th edn. Arnold E: London, Sydney, Auckland, 1998, pp 54–401.

    Google Scholar 

  9. Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113: 1213–1225.

    Article  CAS  Google Scholar 

  10. Asmar RG, London GM, O'Rourke ME, Safar ME . Improvement in blood pressure, arterial stiffness and wave reflections with a very-low-dose perindopril/indapamide combination in hypertensive patient: a comparison with atenolol. Hypertension 2001; 38: 922–926.

    Article  CAS  Google Scholar 

  11. Chen CH, Nevo E, Fetics B, Pak PH, Yin FC, Maughan WL et al. Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function. Circulation 1997; 95: 1827–1836.

    Article  CAS  Google Scholar 

  12. Karamanoglu M, O'Rourke MF, Avolio AP, Kelly RP . An analysis of the relationship between central aortic and peripheral upper limb pressure waves in man. Eur Heart J 1993; 14: 160–167.

    Article  CAS  Google Scholar 

  13. Laurent S, Caviezel B, Beck L, Girerd X, Billaud E, Boutouyrie P et al. Carotid artery distensibility and distending pressure in hypertensive humans. Hypertension 1994; 23: 878–883.

    Article  CAS  Google Scholar 

  14. London GM, Guerin AP, Marchais SJ, Pannier B, Safar ME, Day M et al. Cardiac and arterial interactions in end-stage renal disease. Kidney Int 1996; 50: 600–608.

    Article  CAS  Google Scholar 

  15. Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby DE, Webb DJ . The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol 2000; 525 (Pt 1): 263–270.

    Article  CAS  Google Scholar 

  16. de Luca N, Asmar RG, London GM, O'Rourke MF, Safar ME . Selective reduction of cardiac mass and central blood pressure on low-dose combination perindopril/indapamide in hypertensive subjects. J Hypertens 2004; 22: 1623–1630.

    Article  CAS  Google Scholar 

  17. Saiki RK . Analysis of enzymatically amplified β-globin and HLA-DQα DNA with allele-specific oligonucleotide probes. Nature 1986; 324: 163–166.

    Article  CAS  Google Scholar 

  18. Verbeke F, Segers P, Heireman S, Vanholder R, Verdonck P, Van Bortel LM . Noninvasive assessment of local pulse pressure: importance of brachial-to-radial pressure amplification. Hypertension 2005; 46: 244–248.

    Article  CAS  Google Scholar 

  19. Luft FC . Molecular genetics of human hypertension. J Hypertens 1998; 16: 1871–1878.

    Article  CAS  Google Scholar 

  20. Mitchell GF, DeStefano AL, Larson MG, Benjamin EJ, Chen MH, Vasan RS et al. Heritability and a genome-wide linkage scan for arterial stiffness, wave reflection, and mean arterial pressure: the Framingham Heart Study. Circulation 2005; 112: 194–199.

    Article  Google Scholar 

  21. Ylitalo A, Airaksinen KE, Hautanen A, Kupari M, Carson M, Virolainen J et al. Baroreflex sensitivity and variants of the renin angiotensin system genes. J Am Coll Cardiol 2000; 35: 194–200.

    Article  CAS  Google Scholar 

  22. Rajput C, Makhijani K, Norboo T, Afrin F, Sharma M, Pasha ST et al. CYP11B2 gene polymorphisms and hypertension in highlanders accustomed to high salt intake. J Hypertens 2005; 23: 79–86.

    Article  CAS  Google Scholar 

  23. Safar ME, Simon AC, Dard SA, Parlier HR, Pauleau NE, Vincent ML et al. Aldosterone in sustained essential hypertension. Clin Endocrinol (Oxf) 1982; 16: 77–88.

    Article  CAS  Google Scholar 

  24. Stolarz K, Staessen JA, Kawecka-Jaszcz K, Brand E, Bianchi G, Kuznetsova T et al. Genetic variation in CYP11B2 and AT1R influences heart rate variability conditional on sodium excretion. Hypertension 2004; 44: 156–162.

    Article  CAS  Google Scholar 

  25. Heindl S, Holzschneider J, Hinz A, Sayk F, Fehm HL, Dodt C . Acute effects of aldosterone on the autonomic nervous system and the baroreflex function in healthy humans. J Neuroendocrinol 2006; 18: 115–121.

    Article  CAS  Google Scholar 

  26. Monahan KD, Leuenberger UA, Ray CA . Aldosterone impairs baroreflex sensitivity in healthy adults. Am J Physiol Heart Circ Physiol 2007; 292: H190–H197.

    Article  CAS  Google Scholar 

  27. Smulyan H, Siddiqui DS, Carlson RJ, London GM, Safar ME . Clinical utility of aortic pulses and pressures calculated from applanated radial-artery pulses. Hypertension 2003; 42: 150–155.

    Article  CAS  Google Scholar 

  28. Blacher J, Amah G, Girerd X, Kheder A, Ben Mais H, London GM et al. Association between increased plasma levels of aldosterone and decreased systemic arterial compliance in subjects with essential hypertension. Am J Hypertens 1997; 10: 1326–1334.

    Article  CAS  Google Scholar 

  29. Mahmud A, Feely J . Aldosterone-to-renin ratio, arterial stiffness, and the response to aldosterone hypertension. Am J Hypertens 2005; 18: 50–55.

    Article  CAS  Google Scholar 

  30. Pojoga L, Gautier S, Blanc H, Guyene TT, Poirier O, Cambien F et al. Genetic determination of plasma aldosterone levels in essential hypertension. Am J Hypertens 1998; 11: 856–860.

    Article  CAS  Google Scholar 

  31. White PC, Hautanen A, Kupari M . Aldosterone synthase (CYP11B2) polymorphisms and cardiovascular function. Endocr Res 1998; 24: 797–804.

    Article  CAS  Google Scholar 

  32. Young M, Fullerton M, Dilley R, Funder J . Mineralocorticoids, hypertension, and cardiac fibrosis. J Clin Invest 1994; 93: 2578–2583.

    Article  CAS  Google Scholar 

  33. Weber KT, Brilla CG, Campbell SE, Guarda E, Zhou G, Sriram K . Myocardial fibrosis: role of angiotensin II and aldosterone. Basic Res Cardiol 1993; 88 (Suppl 1): 107–124.

    CAS  PubMed  Google Scholar 

  34. Lacolley P, Labat C, Pujol A, Delcayre C, Benetos A, Safar M . Increased carotid wall elastic modulus and fibronectin in aldosterone-salt-treated rats: effects of eplerenone. Circulation 2002; 106: 2848–2853.

    Article  CAS  Google Scholar 

  35. Schiffrin EL . Effects of aldosterone on the vasculature. Hypertension 2006; 47: 312–318.

    Article  CAS  Google Scholar 

  36. Silvestre JS, Robert V, Heymes C, Aupetit-Faisant B, Mouas C, Moalic JM et al. Myocardial production of aldosterone and corticosterone in the rat. Physiological regulation. J Biol Chem 1998; 273: 4883–4891.

    Article  CAS  Google Scholar 

  37. Hatakeyama H, Miyamori I, Fujita T, Takeda Y, Takeda R, Yamamoto H . Vascular aldosterone. Biosynthesis and a link to angiotensin II-induced hypertrophy of vascular smooth muscle cells. J Biol Chem 1994; 269: 24316–24320.

    CAS  PubMed  Google Scholar 

  38. Takeda Y, Miyamori I, Yoneda T, Hatakeyama H, Inaba S, Furukawa K et al. Regulation of aldosterone synthase in human vascular endothelial cells by angiotensin II and adrenocorticotropin. J Clin Endocrinol Metab 1996; 81: 2797–2800.

    CAS  PubMed  Google Scholar 

  39. Wang Jr J, O'Brien AB, Shrive NG, Parker KH, Tyberg JV . Time-domain representation of ventricular-arterial coupling as a windkessel and wave system. Am J Physiol Heart Circ Physiol 2003; 284: 111358–111368.

    Google Scholar 

  40. Tyberg JV, Davies JE, Wang Z, Whitelaw WA, Flewitt JA, Shrive NG et al. Wave intensity analysis and the development of the reservoir wave approach. Med Biol Eng Comput 2009; 47: 221–232.

    Article  Google Scholar 

  41. Hughes AD, Parker KH . Forward and backward waves in the arterial system: impedance or wave intensity analysis? Med Biol Eng Comput 2009; 47: 207–210.

    Article  CAS  Google Scholar 

  42. Connell JM, Fraser R, MacKenzie Davies SE . Is altered adrenal steroid biosynthesis a key intermediate phenotype in hypertension? Hypertension 2003; 41: 993–999.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was performed with the help of INSERM (Institut de la Santé et de la Recherche Médicale), Paris and GPH-CV (Groupe de Pharmacologie et d'Hémodynamique Cardiovasculaire). We thank Mrs Debouté for excellent assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M E Safar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Blacher, J., Kakou, A., Lacombe, JM. et al. Preferential association of aldosterone synthase gene polymorphism with central blood pressure and wave reflections in hypertensive individuals. J Hum Hypertens 24, 291–299 (2010). https://doi.org/10.1038/jhh.2009.59

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/jhh.2009.59

Keywords

Search

Quick links