Aldosterone in the ovarian cycle of low renin hypertensive women.

Aldosterone in the Ovarian Cycle of Low Renin Hypertensive Women. E. Fommei, S. Maffei, S. Ghione, A. Iervasi, C. Prontera. Institute of Clinical Physiology, C.N.R., Pisa, Italy "ish2006ab" <ish2006ab@congre.co.jp> Abstract Registration [11693] Objective. We previously reported an increase in plasma aldosterone levels during the luteal phase of the menstrual cycle in low renin hypertensive women. Recent in vitro observations indicate a stimulating effect of LH in aldosterone secreting adenomas (Amigh,2006). We here extend our observations and compare aldosterone changes with those of other hormonal parameters. Design and Method. In fourteen low renin hypertensive women (range 33-53 yrs) plasma was taken at 08:30 hr a.m. and assayed for LH, FSH, 17beta-estradiol, progesterone, aldosterone (ALDO), PRA, cortisol (CORT) and BNP during one menstrual cycle (at days 7, 14, 21, 28). Results. ALDO levels increased in the luteal phase (ANOVA p<0.005), clearly above the normal range in seven patients in the presence of low PRA. ALDO was related positively to PRA (<0.05), CORT(<0.05) and progesterone (<0.03) but negatively to estrogen (p<0.05) and BNP (p<0.005), the last two being directly related to each other (p<0.01). Conclusions. Our results 1) confirm our previous observations that ALDO may abnormally increase during the menstrual cycle in low renin women; 2) support a possibile role of LH in ALDO stimulation, as recently suggested; 3) suggest that ALDO may increase in response to the natriuretic effect of progesterone whereas estrogen may be opposed by natriuretic peptide. These findings should be considered when examining endocrine cardiovascular profile in women, particularly when screening for primary aldosteronism; in many hypertensive women the occurrence of hyperaldosteronism in the luteal phase could induce or aggravate pre-menstrual syndrome that might be relieved by aldosterone antagonist therapy.