THE RELATIONSHIP BETWEEN LEVELS OF ALDOSTERONE, ESTRADIOL AND SERUM MARKERS OF ENDOTHELIAL DYSFUNCTION IN HYPERTENSIVE WOMEN

Abstract

Objective: To study the relationship between plasma levels of aldosterone, estradiol and serum markers of endothelial dysfunction (ED) such as stable nitric oxide metabolites NO2-+NO3- (NOx), endothelin-1 (ET-1), homocysteine (HC), von Willebrand factor (vWF) in nondiabetic women with essential hypertension (EH). Design and method: We examined 79 hypertensive, nondiabetic women (mean age 51,4 ± 6,5y, mean EH duration 8,5 ± 7,6y). 28% of the group were smokers, 54% were obese, 76% - with dyslipidemia. Regular menstrual function had 30% of the women, the rest of the group – postmenopausal (median duration of postmenopause was 5,7 ± 3,5y). Circulating NOx levels were studied by spectrophotometry, ET-1, HC, vWF levels – by immunoenzyme assay, aldosterone and estrogen levels - by immunoenzyme assay. Statistical analysis was done using the Statistica 10.0 software. Results: We compared the levels of ED markers in women with a normal (56%), and elevated levels of aldosterone (44%), as well as in women with a normal (62%) and low levels of estradiol (38%). Women with hiperaldosteronemia had higher concentration of NOx (45.3 ± 17.6 and 38.8 ± 16.5 mmol/l, respectively, p < 0.05), E-1 (1.4 ± 1.1 and 0.9 ± 0.8 fmol/l, respectively, p < 0.05) and vWF (1.6 ± 0.8 and 1.3 ± 0.9 mg/dl, respectively, p < 0.05). Aldosterone levels correlated with NOx (r = 0.36, p < 0.05), E-1 (r = 0.3, p < 0.05) and vWF (r = 0.34, p < 0.05) levels. Women with hypoestrogenemia had higher NOx (46.3 ± 16.9 and 37.5 ± 16.0 mmol/l, respectively, p < 0.05), E-1 (1.5 ± 1.1 and 0.8 ± 0.4 fmol/l, respectively, p < 0.05) and vWF (1.6 ± 0.9 and 1.2 ± 0.7 mg/dl, respectively, p < 0.05) levels as well. Estradiol levels correlated with NOx (r = -0.6, p < 0.05) and vWF (r = -0.5, p < 0.05) levels. Conclusions: Our results suggest that women in perimemopausal period demonstrate hormonal disorders with elevation of aldosterone level and decline of estrogen level, which are related to the increase of a number of substances considered as the markers of endothelial dysfunction.