Diuretic-Induced Potassium Depletion and Glucose Intolerance Are Not Related to Hyperactivity of the Renin-Angiotensin-Aldosterone System in Hypertensive Patients With the Metabolic Syndrome

Diuretic-Induced Potassium Depletion and Glucose Intolerance Are Not Related to Hyperactivity of the Renin-Angiotensin-Aldosterone System in Hypertensive Patients With the Metabolic Syndrome

Author Barbieri, Douglas E. Autor UNIFESP Google Scholar
Ribeiro Filho, Fernando Flexa Autor UNIFESP Google Scholar
Ribeiro, Artur B. Google Scholar
Zanella, Maria T. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract The metabolic syndrome (MS) has been associated with hyperactivity of the renin-angiotensin-aldosterone system (RAAS). To assess the hypothesis that diuretic therapy in MS patients through further stimulation of RAAS would elicit greater potassium (K) depletion, two groups of hypertensive patients with (MS group [MSG]; n=20) and without (control group [CG]; n=19) MS were studied. Plasma renin activity (PRA), aldosterone (PA), and K levels were determined and an oral glucose tolerance test with plasma insulin determinations for calculation of homeostasis model assessment of insulin resistance (HOMA-IR), sensitivity (ISI), and secretion (HOMA-beta) was performed, both before and 12 weeks after hydrochlorothiazide (HCT; 25 mg/d) therapy. At baseline, higher HOMA IR and HOMA-beta and lower ISI and plasma K were found in the MSG than in the CG, with no differences in PA and PRA between groups. With therapy, PRA increased similarly in both groups while PA increased only in the MSG. However, greater reduction in plasma K occurred in the CG, and the 2 groups reached similar final K values. Impairment in glucose tolerance occurred in both groups, with no change in HOMA-beta in the CG and reduction in the MSG, suggesting that diuretic therapy increases insulin resistance and impairs insulin secretion independent of abdominal obesity. These alterations could not be attributed to hyperactivity of RAAS.
Language English
Date 2009-10-01
Published in Journal of Clinical Hypertension. Malden: Wiley-Blackwell Publishing, Inc, v. 11, n. 10, p. 549-554, 2009.
ISSN 1524-6175 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 549-554
Origin http://dx.doi.org/10.1111/j.1751-7176.2009.00164.x
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000270588700004
URI http://repositorio.unifesp.br/handle/11600/31838

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