Comparison of Copeptin Levels in Non- Dipper and Dipper Hypertension Patients
Year 2022,
Volume: 19 Issue: 3, 456 - 461, 27.12.2022
Mehmet Altın
,
Musluhittin Erkus
,
Halil Fedai
,
Özgür Günebakmaz
Abstract
Background: Hypertension is an important risk factor for cardiovascular diseases. Studies with ambulatory blood pressure monitoring (ABPM) have revealed that blood pressure changes during the day and has a circadian rhythm. Decreasing 10% or above in blood pressure during the night is called dipper; if not so is called non-dipper hypertension(HT). Cardiovascular risk increases in patients with non-dipper hypertension. Copeptin ise antidiüretik hormonun parçası olan bir molüküldür. In some studies, copeptin level in the blood shows a rapid increase in conditions such as cardiovascular diseases, cerebrovascular diseases, sepsis and shock. In this study, we aimed to compare serum copeptin levels in dipper and non-dipper patient groups.
Materials and Methods: 73 patients newly diagnosed with HT were included in this study as the study group and 35 healthy individuals as the control group. Individuals diagnosed with HT were divided into dipper HT and non-dipper HT subgroups according to ABPM. The basic biochemical parameters and copeptin levels of all individuals included in the study were studied.
Results: Serum copeptin levels of individuals with non-dipper HT were found to be significantly higher than serum copeptin levels in both control and dipper patient groups. A positive correlation was observed between copeptin and triglyceride in double correlation analysis. No statistically significant correlation was found between other biochemical markers and copeptin.
Conclusion: Serum copeptin levels were found to be high in the non-dipper hypertensive patient group with a poor prognostic course. This finding suggests that increased copeptin level is associated with the prognosis of patients with non-dipper HT. Therefore, copeptin level can be used as a prognostic parameter in patients with hypertension.
References
- 1. Brunton LL, Lazo JS, Parker KL. Goodman & Gilman's The Pharmacological Basis of Therapeutics Eleventh Edition McGraw-Hill, 2006; 845-50.
- 2. Bonow RO, Mann DL, Zipes DP, Libby P. Braunwald's Heart Disease A Textbook of Cardiovascular Medicine. Ninth Edition. Saunders, chapter 2011; 45-6.
- 3. Mathers C SG, Mascarenhas M. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, Switzerland: World Health Organization; 2009
- 4. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39:3021-104.
- 5. Moser M, Hebert PR. Prevention of disease progression, leftventricular hypertrophy and congestive heart failure in hypertension treatment trials. J Am Coll Cardiol 1996; 27: 1214-8.
- 6. Kobrin I, Oigman W, Kumar A, Ventura HO, Messerli FH, Frohlich ED et al. Diurnal variation of blood pressure in elderly patients with essential hypertension. J Am Geriatr Soc. 1984;32:896-9.
- 7. Shimada K, Kawamoto A, Matsubayashi K, Nishinaga M, Kimura S, Ozawa T. Diurnal blood pressure variations and silent cerebrovascular damage in elderly patients with hypertension. J Hypertens. 1992;10:875-8.
- 8. Morgenthaler NG, Müller B, Struck J, Bergmann A, Redl H, Christ-Crain M. Copeptin, a stable peptide of the arginine vasopressin precursor, is elevated in hemorrhagic and septic shock. Shock. 2007;28:219-26.
- 9. Land H, Schütz G, Schmale H, Richter D. Nucleotide sequence of cloned cDNA encoding bovine arginine vasopressin-neurophysin II precursor. Nature. 1982 ;295:299-303.
- 10. Holwerda DA. A glycopeptide from the posterior lobe of pig pituitaries. I. Isolation and characterization. Eur J Biochem 1972; 28: 334-9.
- 11. Khan SQ, Dhillon OS, O'Brien RJ, Struck J, Quinn PA, Morgenthaler NG et al. C-terminal provasopressin (copeptin) as a novel and prognostic marker in acute myocardial infarction: Leicester Acute Myocardial Infarction Peptide (LAMP) study. Circulation. 2007;115:2103-10.
- 12. Morgenthaler NG. Copeptin: A Biomarker of Cardiovascular and Renal Function. Congest Heart Fail 2010;16: 37–44.
- 13. Chai SB, Hui YM, Li XM, Xiao Y, Tang CS. Plasma levels of copeptin in patients with coronary heart disease. Heart Vessels. 2009;24:79-83.
- 14. O'Brien E, Sheridan J, O'Malley K. Dippers and non-dippers. Lancet 1988;2:397.
- 15. Verdecchia P, Schillaci G, Porcellati C. Dippers versus non-dippers. J hyperten Suppl 1991;9:42-4.
- 16. Kurpesa M, Trzos E, Drozdz J, Bednarkiewicz Z, Krzemińska-Pakuła M. Myocardial ischemia and autonomic activity in dippers and non-dippers with coronary artery disease: assessment of normotensive and hypertensive patients. Int J Cardiol. 2002;83:133-42.
- 17. Kang SJ, Lim HS, Choi BJ, Choi SY, Hwang GS, Yoon MH, et al. Longitudinal strain and torsion assessed by two-dimensional speckle tracking correlate with the serum level of tissue inhibitor of matrix metalloproteinase-1, a marker of myocardial fibrosis, in patients with hypertension. J Am Soc Echocardiogr. 2008:29;907-11.
- 18. Verdecchia P, Schillaci G, Porcellati C. Dippers versus non-dippers. J hyperten Suppl 1991; 9: 42-4.
- 19. Katan M, Morgenthaler N, Widmer I, Puder JJ, König C, Müller B et al. Copeptin, a stable peptide derived from the vasopressin precursor, correlates with the individual stress level. Neuro Endocrinol Lett. 2008;29:341-6.
- 20. Nils G. Morgenthaler, MD, MBA Copeptin: A Biomarker of Cardiovascular and Renal Function. Congest Heart Fail 2010;16:37-44.
- 21. Verdecchia P, Schillaci G, Borgioni C, Ciucci A, Pede S, Porcellati C. Ambulatory pulse pressure: a potent predictor of total cardiovascular risk in hypertension. Hypertension. 1998;32:983-8.
Non-dipper ve Dipper Hipertansiyonlu Hastalardaki Copeptin Düzeyinin Karşılaştırması
Year 2022,
Volume: 19 Issue: 3, 456 - 461, 27.12.2022
Mehmet Altın
,
Musluhittin Erkus
,
Halil Fedai
,
Özgür Günebakmaz
Abstract
Amaç: Kardiyovasküler hastalıklar açısından hipertansiyon önemli bir risk faktörüdür. Amblatuvar kan basıncı monitörizasyonu(AKBM) ile yapılan çalışmalar kan basıncının gün içerisinde değiştiğini ve sirkadiyen bir ritminin olduğunu ortaya koymuştur. Kan basıncında gece % 10 veya daha fazla düşme olması dipper hipertansiyon (HT), olmaması non-dipper HT olarak nitelendirilmiştir. Non-dipper HT’li hastalarda kardiyovasküler riskin arttığı gösterilmiştir. Copeptin ise antidiüretik hormonun parçası olan bir molüküldür. Bazı çalışmalarda kardiyovasküler hastalıklar, serebrovasküler hastalıklar, sepsis ve şok gibi durumlarda kanda copeptin düzeyi hızlı bir yükseliş göstermektedir. Bu çalışmada dipper ve non-dipper hasta gruplarında serum copeptin düzeylerini karşılaştırmayı amaçladık.
Materyal ve Metod: Bu çalışmaya yeni HT tanısı konulan 73 hasta çalışma grubu olarak ve 35 sağlıklı bireyde kontrol grubu olarak dahil edildi. HT tanısı konulan bireyler AKBM göre dipper HT ve non-dipper HT alt gruplarına ayrıldı. Çalışmaya alınan tüm bireylerin temel biyokimyasal parametreleri ve copeptin düzeyleri çalışıldı.
Bulgular: Non-dipper HT'u olan bireylerin serum copeptin düzeyleri, hem kontrol hem dipper hasta grubuna göre serum copeptin düzeylerinden anlamlı olarak daha yüksek bulundu. İkili korolerasyon analizlerinde copeptin ile trigliserid arasında pozitif korelasyon görüldü. Diğer biyokimyasal belirteçler ile copeptin arasında istatistiksel olarak anlamlı bir ilişki bulunamadı.
Sonuç: Serum copeptin düzeyleri prognoztik olarak kötü seyreden non-dipper hipertansif olan hasta grubunda yüksek saptandı. Bu bulgu artmış copeptin düzeyinin non-dipper HT’u olan hastaların prognozu ile ilişkili olduğunu düşündürmektedir. Bu nedenle copeptin düzeyi hipertansiyonlu hastalarda bir prognoztik parametre olarak kullanılabilir.
References
- 1. Brunton LL, Lazo JS, Parker KL. Goodman & Gilman's The Pharmacological Basis of Therapeutics Eleventh Edition McGraw-Hill, 2006; 845-50.
- 2. Bonow RO, Mann DL, Zipes DP, Libby P. Braunwald's Heart Disease A Textbook of Cardiovascular Medicine. Ninth Edition. Saunders, chapter 2011; 45-6.
- 3. Mathers C SG, Mascarenhas M. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, Switzerland: World Health Organization; 2009
- 4. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39:3021-104.
- 5. Moser M, Hebert PR. Prevention of disease progression, leftventricular hypertrophy and congestive heart failure in hypertension treatment trials. J Am Coll Cardiol 1996; 27: 1214-8.
- 6. Kobrin I, Oigman W, Kumar A, Ventura HO, Messerli FH, Frohlich ED et al. Diurnal variation of blood pressure in elderly patients with essential hypertension. J Am Geriatr Soc. 1984;32:896-9.
- 7. Shimada K, Kawamoto A, Matsubayashi K, Nishinaga M, Kimura S, Ozawa T. Diurnal blood pressure variations and silent cerebrovascular damage in elderly patients with hypertension. J Hypertens. 1992;10:875-8.
- 8. Morgenthaler NG, Müller B, Struck J, Bergmann A, Redl H, Christ-Crain M. Copeptin, a stable peptide of the arginine vasopressin precursor, is elevated in hemorrhagic and septic shock. Shock. 2007;28:219-26.
- 9. Land H, Schütz G, Schmale H, Richter D. Nucleotide sequence of cloned cDNA encoding bovine arginine vasopressin-neurophysin II precursor. Nature. 1982 ;295:299-303.
- 10. Holwerda DA. A glycopeptide from the posterior lobe of pig pituitaries. I. Isolation and characterization. Eur J Biochem 1972; 28: 334-9.
- 11. Khan SQ, Dhillon OS, O'Brien RJ, Struck J, Quinn PA, Morgenthaler NG et al. C-terminal provasopressin (copeptin) as a novel and prognostic marker in acute myocardial infarction: Leicester Acute Myocardial Infarction Peptide (LAMP) study. Circulation. 2007;115:2103-10.
- 12. Morgenthaler NG. Copeptin: A Biomarker of Cardiovascular and Renal Function. Congest Heart Fail 2010;16: 37–44.
- 13. Chai SB, Hui YM, Li XM, Xiao Y, Tang CS. Plasma levels of copeptin in patients with coronary heart disease. Heart Vessels. 2009;24:79-83.
- 14. O'Brien E, Sheridan J, O'Malley K. Dippers and non-dippers. Lancet 1988;2:397.
- 15. Verdecchia P, Schillaci G, Porcellati C. Dippers versus non-dippers. J hyperten Suppl 1991;9:42-4.
- 16. Kurpesa M, Trzos E, Drozdz J, Bednarkiewicz Z, Krzemińska-Pakuła M. Myocardial ischemia and autonomic activity in dippers and non-dippers with coronary artery disease: assessment of normotensive and hypertensive patients. Int J Cardiol. 2002;83:133-42.
- 17. Kang SJ, Lim HS, Choi BJ, Choi SY, Hwang GS, Yoon MH, et al. Longitudinal strain and torsion assessed by two-dimensional speckle tracking correlate with the serum level of tissue inhibitor of matrix metalloproteinase-1, a marker of myocardial fibrosis, in patients with hypertension. J Am Soc Echocardiogr. 2008:29;907-11.
- 18. Verdecchia P, Schillaci G, Porcellati C. Dippers versus non-dippers. J hyperten Suppl 1991; 9: 42-4.
- 19. Katan M, Morgenthaler N, Widmer I, Puder JJ, König C, Müller B et al. Copeptin, a stable peptide derived from the vasopressin precursor, correlates with the individual stress level. Neuro Endocrinol Lett. 2008;29:341-6.
- 20. Nils G. Morgenthaler, MD, MBA Copeptin: A Biomarker of Cardiovascular and Renal Function. Congest Heart Fail 2010;16:37-44.
- 21. Verdecchia P, Schillaci G, Borgioni C, Ciucci A, Pede S, Porcellati C. Ambulatory pulse pressure: a potent predictor of total cardiovascular risk in hypertension. Hypertension. 1998;32:983-8.