Adipose-secreted signals associated with different clinical BP phenotypes

11 March 2010

MedWire News: Normal blood pressure (BP) and white-coat hypertension are associated with a more favorable circulating adipokine pattern than masked or sustained hypertension, Greek researchers report.

Increased plasma resistin and decreased adiponectin were associated with out-of-clinic hypertension.

Elevated resistin was associated approximately 2.5 times more frequently with sustained hypertension than masked hypertension, whereas adiponectin determined these phenotypes to a similar extent.

Resistin and adiponectin have opposite effects on insulin sensitivity, regulation of endothelial function, and systemic inflammatory load, say C Thomopoulos (Elena Venizelou General and Maternity Hospital, Athens) and colleagues.

They studied these adipose-secreted signals in 328 untreated White adults who referred themselves to an outpatient hypertensive clinic for BP evaluation.

Participants did not have diabetes, impaired glucose metabolism, a history of cardiovascular disease or another concurrent condition, secondary hypertension, or ongoing vasoactive treatment.

Based on three separate clinic BP measurements and ambulatory BP monitoring, the group was divided into 105 hypertensive individuals, 41 masked hypertensives, 52 white-coat hypertensives, and 130 normotensives.

Participants with hypertension or masked hypertension showed higher log(10) resistin levels and lower log(10) adiponectin levels than normotensives.

In white-coat hypertensive individuals, levels of both adipokines were similar to those in normotensives.

Resistin and adiponectin levels correlated with 24-hour systolic BP, the standing/sitting difference in both diastolic BP and heart rate, and waist circumference.

Hypertension and masked hypertension were independently associated with increased log(10) resistin levels, with odds ratios of 1.24 and 1.16, respectively, compared with normal BP. Both were also independently associated with decreased log(10) adiponectin levels, with corresponding odds ratios of 0.74 and 0.81.

Reporting in the Journal of Human Hypertension, the researchers say: “These findings suggest that inappropriate levels of circulating adipose tissue-secreted signals, namely hyperresistinemia and hypoadiponectinemia, may accompany the out-of-clinic hypertensive BP phenotypes identified either as sustained or masked hypertension, possibly resembling an obscured hemodynamic pressor lever.”

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J Hum Hypertens 2010: Advance online publication