ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
Effects of valsartan treatment on serum ghrelin level and left ventricular mass index in patients with untreated primary hypertension [Anatol J Cardiol]
Anatol J Cardiol. 2014; 14(3): 234-238 | DOI: 10.5152/akd.2014.4738

Effects of valsartan treatment on serum ghrelin level and left ventricular mass index in patients with untreated primary hypertension

Coşkun Meriç1, Aydoğan Aydoğdu2, İlker Taşçı3, Ferhat Deniz1, Oben Baysan5, Muhittin Serdar6, Kenan Sağlam7, Ömer Azal8
1Department of Endocrinology, Gülhane School of Medicine, Ankara-Turkey
2Department of Endocrinology and Metabolism, Gülhane School of Medicine, Ankara-Turkey
3Department of Geriatrics, Gülhane School of Medicine, Ankara-Turkey
4Department of Endocrinology, Gülhane School of Medicine, Ankara-Turkey
5Clinic of Cardiology, Ankara Güven Hospital, Ankara-Turkey
6Department of Biochemistry, Gülhane School of Medicine, Ankara-Turkey
7Department of Internal Medicine, Gülhane School of Medicine, Ankara-Turkey
8Departments of Endocrinology Internal Medicine, Gülhane School of Medicine, Ankara-Turkey

Objective: In the present study, left ventricular hypertrophy and serum ghrelin concentration in patients with primary hypertension and effects of angiotensin receptor blocker valsartan on these parameters were determined. Methods: Thirty-seven patients and 30 age and body mass index matched healthy controls were followed up prospectively. Serum ghrelin level was measured by enzyme immunoassay (EIA). Left ventricular mass was determined by transthoracic echocardiography. Left ventricular mass index (LVMI) was calculated by dividing the left ventricular mass to body surface area. All patients were started treatment with oral valsartan 80 mg. Follow-up visits were performed every 4 weeks, and the dosage was doubled in subjects with insufficient blood pressure reduction. At the end of the 12th week all measurements were repeated in the patient group. All data were recorded in the computer using SPSS for Windows software. Mann-Whitney U, Student t, Wilcoxon and t tests were used for statistical analyses. Results: At baseline, mean serum ghrelin level was significantly lower in the patients group (14.9 ng/mL) compared to healthy controls (42.1 ng/mL) (p<0.05). After a 12-week antihypertensive treatment of patients, serum ghrelin concentration increased while LVMI decreased (p<0.05, for both). No significant correlation was found between Δ-ghrelin level and Δ-LVMI (r=0.155, p=0.368). Conclusion: Low circulating level of ghrelin in patients with hypertension and its increase after antihypertensive treatment suggest that this peptide need to be explored in the mechanism and complications of hypertension.

Keywords: hypertension, left ventricular mass index, ghrelin, valsartan

Tedavi almamış primer hipertansif hastalarda valsartanın serum ghrelin düzeyi ve sol ventrikül kitle indeksi üzerindeki etkileri

Coşkun Meriç1, Aydoğan Aydoğdu2, İlker Taşçı3, Ferhat Deniz1, Oben Baysan5, Muhittin Serdar6, Kenan Sağlam7, Ömer Azal8
1Department of Endocrinology, Gülhane School of Medicine, Ankara-Turkey
2Department of Endocrinology and Metabolism, Gülhane School of Medicine, Ankara-Turkey
3Department of Geriatrics, Gülhane School of Medicine, Ankara-Turkey
4Department of Endocrinology, Gülhane School of Medicine, Ankara-Turkey
5Clinic of Cardiology, Ankara Güven Hospital, Ankara-Turkey
6Department of Biochemistry, Gülhane School of Medicine, Ankara-Turkey
7Department of Internal Medicine, Gülhane School of Medicine, Ankara-Turkey
8Departments of Endocrinology Internal Medicine, Gülhane School of Medicine, Ankara-Turkey

Amaç: Bu çalışmada, hipertansif hastalardaki sol ventrikül hipertrofisi ile serum ghrelin düzeyi ve bir anjiyotensin reseptör blokeri olan valsartanın bu parametreler üzerindeki etkisi araştırıldı. Yöntemler: Otuz yedi primer hipertansiyonlu hasta ile yaş ve vücut kitle indeksleri benzer 30 sağlıklı olgu prospektif olarak takip edildi. Serum ghrelin düzeyi enzim immünessay yöntemi ile ölçüldü. Sol ventrikül kitlesi (SVK) transtorasik ekokardiyografi ile ölçüldü. SVK vücut yüzey alanına bölünerek sol ventrikül kitle indeksi (SVKİ) hesaplandı. Kan basıncı kontrolü sağlamak için hastalara öncelikle oral valsartan 80 mg tedavisi başlanmış olup, 4 haftalık kontroller sonrasında kan basıncı regüle olmayanlarda doz 160 mg’a çıkarıldı. 12. haftanın sonundaki kontrolde ilk karşılaşmadaki tetkik ve ölçümler tekrarlandı. Tüm veriler Windows işletim sisteminde SPSS programı kullanılarak bilgisayara kaydedildi. İstatistiksel analizler için, Mann-Whitney U, Student t, Wilcoxon ve t testleri kullanıldı. Bulgular: Çalışma başlangıcında hasta kolunda (14,9 ng/mL) sağlıklı bireylere göre (42,1 ng/mL) serum ghrelin düzeyleri anlamlı düşük bulundu (p<0,05). On iki haftalık bir antihipertansif tedavi sonrasında serum ghrelin düzeyi anlamlı olarak artış gösterirken, SVKİ anlamlı olarak azaldı (p<0,05). Sol ventrikül kitle indeksi ile serum ghrelin düzeyleri arasında, tedavi sonrası ve tedavi öncesi değerler arasındaki fark açısından (Δ-ghrelin, Δ-SVKİ) anlamlı korelasyon tespit edilmedi (r=0,155, p=0,368). Sonuç: Serum ghrelin düzeyinin kan basıncı yüksek bireylerde düşük bulunması ve antihipertansif tedavi ile artış göstermesi ghrelinin hipertansiyon ve komplikasyonlarının patogenezinde incelenmesi gereken bir hormon olduğunu düşündürmektedir.

Anahtar Kelimeler: hipertansiyon, sol ventrikül kitle indeksi, ghrelin, valsartan

Coşkun Meriç, Aydoğan Aydoğdu, İlker Taşçı, Ferhat Deniz, Oben Baysan, Muhittin Serdar, Kenan Sağlam, Ömer Azal. Effects of valsartan treatment on serum ghrelin level and left ventricular mass index in patients with untreated primary hypertension. Anatol J Cardiol. 2014; 14(3): 234-238
Manuscript Language: English


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