Endocrine disturbances and hormonal dysbalance types in criseJassociated primary arterial hypertension

Abstract

To assess the prevalence and type of changes in endocrine organ status and hormonal levels, as well as to investigate their possible role in hypertensive crise development among patients with Stage I?III primary arterial hypertension, AH (WHO classification, 1997), 563 persons with diagnosed hypertensive crise were examined (189 men and 374 women aged 19–67 years). The comparison group included 619 patients (207 men and 412 women aged 25–66 years) with AH of similar severity, but without crises. Clinical, biochemical, and instrumental search for possible AH causes was performed. Basal blood concentrations of hormones and other bio?substances in blood plasma and urine were measured by radio?immune method, at Days 1–7 and 18–22 of hospitalization (ACTH, LH, STH, FSH, prolactin, aldosterone, cortisol, thyroxin, triiodthyronin, thyroxin?binding globulin, insulin, C?peptide, estradiol, testosterone, calcitonin, parathyroid hormone, gastrin, renin, cAMP and cGMP). In crise?associated primary AH, the levels of hypophysis tropic hormones were elevated (thyrotropin, in women of reproductive and menopausal age – gonadotropins LH, FSH, and prolactin), without any signs of hypophysis pathology during instrumental examination. Crise?associated AH was characterized by low?renin hyperaldosteronism, with suprarenal pathology signs, but without symptoms of fluid detention. In patients with AH crises, metabolic syndrome components (obesity, dyslipoproteinemia, hyperinsulinemia) were more common. Frequent AH crises were associated with basal hyperinsulinemia and dysbalance in urine cAMP/cGMP excretion.

Keywords

• primary arterial hypertension
• crises
• hormonal disturbances