Hypertension. 2005;45:356-362
Published online before print January 3, 2005, doi: 10.1161/01.HYP.0000154361.47683.d3
Published online before print January 3, 2005, doi: 10.1161/01.HYP.0000154361.47683.d3
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(Hypertension. 2005;45:356.)
© 2005 American Heart Association, Inc.
Original Articles |
Weight Loss and the Renin-Angiotensin-Aldosterone System
From Medical Faculty of the Charité (S.E., J.B., K.G., J.J., M.B., F.C.L.), Franz Volhard Clinic and Max Delbrück Center for Molecular Medicine, HELIOS-Klinikum, Berlin, Germany; Institute for Clinical Chemistry and Laboratory Medicine (P.S.), University of Regensburg, Germany; Department of Medicine (A.M.S.), McMaster University, Hamilton, Ontario, Canada.
Correspondence to Stefan Engeli, MD, Franz-Volhard-Klinik (Haus 129), Wiltbergstraße 50, 13125 Berlin, Germany. E-mail engeli{at}fvk.charite-buch.de
Abstract
The renin-angiotensin-aldosterone system has been causally implicated in obesity-associated hypertension. We studied the influence of obesity and weight reduction on the circulating and adipose tissue renin-angiotensin-aldosterone system in menopausal women. Blood samples were analyzed for angiotensinogen, renin, aldosterone, angiotensin-converting enzyme activity, and angiotensin II. In adipose tissue biopsy samples, we analyzed angiotensinogen, renin, renin-receptor, angiotensin-converting enzyme, and angiotensin II type-1 receptor gene expression. Obese women (n=19) had higher circulating angiotensinogen, renin, aldosterone, and angiotensin-converting enzyme than lean women (n=19), and lower angiotensinogen gene expression in adipose tissue. Seventeen women successfully participated in a weight reduction protocol over 13 weeks to reduce daily caloric intake by 600 kcal. Body weight was reduced by –5%, as were angiotensinogen levels by –27%, renin by –43%, aldosterone by –31%, angiotensin-converting enzyme activity by –12%, and angiotensinogen expression by –20% in adipose tissue (all P<0.05). The plasma angiotensinogen decrease was highly correlated with the waist circumference decline (r=0.74; P<0.001). Weight and renin-angiotensin-aldosterone system reductions were accompanied by a –7-mm Hg reduced systolic ambulatory blood pressure. These data suggest that a 5% reduction in body weight can lead to a meaningfully reduced renin-angiotensin-aldosterone system in plasma and adipose tissue, which may contribute to the reduced blood pressure.
Key Words: adipose tissue • aldosterone • angiotensinogen • hypertension • obesity • renin
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