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(Hypertension. 2002;39:357.)
© 2002 American Heart Association, Inc.

Scientific Contributions

-Adducin 460Trp Allele Is Associated With Erythrocyte Na Transport Rate in North Sardinian Primary Hypertensives

Nicola Glorioso; Fabiana Filigheddu; Daniele Cusi; Chiara Troffa; Milena Conti; Marcella Natalizio; Giuseppe Argiolas; Cristina Barlassina; Giuseppe Bianchi

From Hypertension Center, University of Sassari Medical School (N.G., F.F., C.T., M.C., M.N., G.A.), Sassari, Italy; Chair and Graduate School of Nephrology, University of Milano (D.C., C.B.); and Chair and Graduate School of Nephrology, Ateneo Vita-Salute San Raffaele, Division of Nephrology, Dialysis and Hypertension, San Raffaele Hospital (G.B.), IRCCS, Milan, Italy.

Correspondence to Nicola Glorioso, MD, Hypertension Center, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy. E-mail glorioso{at}ssmain.uniss.it

Erythrocyte membrane alterations mirror those of vascular smooth muscle and renal tubular cell membrane. The interaction between adducin and Na-K pump is the most likely biochemical mechanism responsible for the increased tubular Na reabsorption and hypertension in Milan hypertensive strain (MHS) rats. To substantiate this hypothesis in humans, we tested to see if -adducin Gly460Trp genotype is associated with erythrocyte sodium transport rate in a new cohort of n=268 never-treated North Sardinian primary hypertensives. Plasma renin activity and blood pressure response to hydrochlorothiazide were also measured to evaluate the relationship between sodium transport rate and two intermediate phenotypes with a higher degree of genetic complexity. Na-K pump, Na-K-Cl cotransport, and Li-Na countertransport at V_max were faster (P<0.0001), whereas intracellular Na concentration was lower (P<0.0001) in patients carrying one or two 460Trp alleles. Such behavior was mirrored by opposite changes of intracellular Na concentration. Plasma renin activity and blood pressure response to diuretic treatment, on the other hand, showed a weaker association with the sodium transport rate. In conclusion, our findings are consistent with the hypothesis that the Gly460Trp -adducin polymorphism may affect renal Na handling through an alteration in ion transport across the cell membrane mirrored by erythrocytes. These results may also have clinical relevance because the Gly460Trp -adducin polymorphism may explain, at least in part, the variability of blood pressure response to diuretics in primary hypertensive patients.

Key Words: hypertension, essential • sodium pump • erythrocytes • genetics • diuretics

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