We have located links that may give you full text access.
[OP.7D.02] INCREASE IN PLASMA COPEPTIN CONCENTRATION IN PATIENTS WITH CONFIRMED RESISTANT ESSENTIAL HYPERTENSION.
Journal of Hypertension 2016 September
OBJECTIVE: The lack of consensus regarding the role of vasopressin in uncontrolled hypertension may be due to the use of assays with limited sensitivity. We used plasma copeptin concentration (PCop), a reliable surrogate marker for plasma vasopressin, to evaluate its role in a large population of patients with resistant (RH) and non-resistant (NRH) essential hypertension.
DESIGN AND METHOD: 166 patients with RH to > = 3 antihypertensive drugs, including a diuretic (office BP > = 140 or 90 mmHg), entered a 4-week standardized treatment with irbesartan 300 mg + HCTZ 12.5 mg + amlodipine 5 mg to confirm RH by ABPM (daytime ambulatory BP > = 135/85 mmHg). We compared PCop, plasma renin (PRC) and aldosterone concentration (PAC) and urine osmolality (Uosm) and estimated glomerular filtration rate (eGFR) after 4 weeks between patients with confirmed RH (n = 140) and NRH (n = 26).
RESULTS: Patients with RH were more frequently men, had significantly lower PRC, but similar PAC than patients with NRH. PCop was about 2-fold higher in patients with RH than in those with NRH (P = 0.001 adjusted on sex, plasma Na, daytime SBP and eGFR) even though similar plasma Na (p = 0.9). RH Uosm, 24-h and urinary output and correlation between Uosm log-PCop did not significantly differ between the two groups.(Figure is included in full-text article.)
CONCLUSIONS: : Patients with RH to a 4-week standardized triple therapy had a 2-fold lower PRC (indicating a persistance of volume expansion) and a 2-fold higher PCop than those of patients NRH. The increase in PCop was not explained by changes in plasma Na, nor by peripheral (renal) resistance to vasopressin. This suggests a primary central stimulation of AVP secretion in RH associated with biological signs of volume expansion.
DESIGN AND METHOD: 166 patients with RH to > = 3 antihypertensive drugs, including a diuretic (office BP > = 140 or 90 mmHg), entered a 4-week standardized treatment with irbesartan 300 mg + HCTZ 12.5 mg + amlodipine 5 mg to confirm RH by ABPM (daytime ambulatory BP > = 135/85 mmHg). We compared PCop, plasma renin (PRC) and aldosterone concentration (PAC) and urine osmolality (Uosm) and estimated glomerular filtration rate (eGFR) after 4 weeks between patients with confirmed RH (n = 140) and NRH (n = 26).
RESULTS: Patients with RH were more frequently men, had significantly lower PRC, but similar PAC than patients with NRH. PCop was about 2-fold higher in patients with RH than in those with NRH (P = 0.001 adjusted on sex, plasma Na, daytime SBP and eGFR) even though similar plasma Na (p = 0.9). RH Uosm, 24-h and urinary output and correlation between Uosm log-PCop did not significantly differ between the two groups.(Figure is included in full-text article.)
CONCLUSIONS: : Patients with RH to a 4-week standardized triple therapy had a 2-fold lower PRC (indicating a persistance of volume expansion) and a 2-fold higher PCop than those of patients NRH. The increase in PCop was not explained by changes in plasma Na, nor by peripheral (renal) resistance to vasopressin. This suggests a primary central stimulation of AVP secretion in RH associated with biological signs of volume expansion.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app