Gender differences in anxiety and depressive symptoms in patients with primary hyperaldosteronism: A cross-sectional study

Apostolopoulou, Konstantina; Künzel, Heike; Gerum, S.; Merkle, Katrin; Schulz, Sebastian; Fischer, Evelyn; Pallauf, Anna; Brand, Volker; Bidlingmaier, Martin; Endres, Stephan; Beuschlein, Felix; Reincke, Martín

doi:10.3109/15622975.2012.665480

Cited by 65 publications

(53 citation statements)

References 69 publications

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“…Häfner et al [31,32] demonstrated specific factors for an increased level of aldosterone in depression, in particular a co-occurrence with arterial hypertension and with social isolation. Further support of a causal role of aldosterone comes from observations that patients with primary hyperaldosteronism frequently show symptoms of depression, anxiety and somatization and a reduced quality of life [33,34,35]. A direct causal involvement of aldosterone is also suggested by animal data: subchronic administration of aldosterone with a minipump led to depression- and anxiety-like behavior in rats [24].…”

Section: Mr and The Stress Hormone Systemmentioning

confidence: 92%

Genetic, Molecular and Clinical Determinants for the Involvement of Aldosterone and Its Receptors in Major Depression

et al. 2014

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Major depression (MDE) has metabolic and neuroendocrine correlates, which point to a biological overlap between MDE and cardiovascular diseases. Whereas the hypothalamic-pituitary-adrenocortical axis has long been recognized for its involvement in depression, the focus was mostly on cortisol/corticosterone, whereas aldosterone appears to be the ‘forgotten' stress hormone. Part of the reason for this is that the receptors for aldosterone, the mineralocorticoid receptors (MR), were thought to be occupied by glucocorticoids in most parts of the brain. However, recently it turned out that aldosterone acts selectively in relevant mood-regulating brain areas, without competing with cortisol/corticosterone. These areas include the nucleus of the solitary tract (NTS), the amygdala and the paraventricular nucleus of the hypothalamus. These regions are intimately involved in the close relationship between emotional and vegetative symptoms. Genetic analysis supports the role of aldosterone and of MR-related pathways in the pathophysiology of depression. Functional markers for these pathways in animal models as well as in humans are available and allow an indirect assessment of NTS function. They include heart rate variability, baroreceptor reflex sensitivity, blood pressure, salt taste sensitivity and slow-wave sleep. MR activation in the periphery is related to electrolyte regulation. MR overactivity is a risk factor for diabetes mellitus and a trigger of inflammatory processes. These markers can be used not only to assist the development of new treatment compounds, but also for a personalized approach to treat patients with depression and related disorders by individual dose titration with an active medication, which targets this system.

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Section: Mr and The Stress Hormone Systemmentioning

confidence: 92%

Genetic, Molecular and Clinical Determinants for the Involvement of Aldosterone and Its Receptors in Major Depression

et al. 2014

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“…PA has been associated with depression (28,262,303), anxiety (21,270,473,474), and even episodic rage (which resolved after unilateral adrenalectomy for APA) (236 …”

Section: Adverse Psychological Effects and Impaired Quality Of Lifementioning

confidence: 99%

“…Nocturia is a common symptom even among patients with normal plasma potassium levels, possibly because of the rise in ANP levels that has been observed among patients with PA, or because an increase in potassium release from renal tubular cells (serving as an attempt to maintain normokalemia) may have led to an intracellular potassium deficit. Patients with PA also frequently describe feelings of lethargy, impaired mental concentration, and mood disturbances (9,21,28,270,473,474,509). During pregnancy, hypertension and symptoms may improve (49,210,424).…”

Section: Symptoms and Signs Of Pamentioning

confidence: 99%

Primary Aldosteronism: Changing Definitions and New Concepts of Physiology and Pathophysiology Both Inside and Outside the Kidney

Stowasser

Gordon

2016

Physiological Reviews

127

134

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In the 60 years that have passed since the discovery of the mineralocorticoid hormone aldosterone, much has been learned about its synthesis (both adrenal and extraadrenal), regulation (by renin-angiotensin II, potassium, adrenocorticotrophin, and other factors), and effects (on both epithelial and nonepithelial tissues). Once thought to be rare, primary aldosteronism (PA, in which aldosterone secretion by the adrenal is excessive and autonomous of its principal regulator, angiotensin II) is now known to be the most common specifically treatable and potentially curable form of hypertension, with most patients lacking the clinical feature of hypokalemia, the presence of which was previously considered to be necessary to warrant further efforts towards confirming a diagnosis of PA. This, and the appreciation that aldosterone excess leads to adverse cardiovascular, renal, central nervous, and psychological effects, that are at least partly independent of its effects on blood pressure, have had a profound influence on raising clinical and research interest in PA. Such research on patients with PA has, in turn, furthered knowledge regarding aldosterone synthesis, regulation, and effects. This review summarizes current progress in our understanding of the physiology of aldosterone, and towards defining the causes (including genetic bases), epidemiology, outcomes, and clinical approaches to diagnostic workup (including screening, diagnostic confirmation, and subtype differentiation) and treatment of PA.

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“…[43][44][45][46][47][48][49][50] There is also mounting evidence for development of type 2 diabetes, insulin resistance and the metabolic syndrome, 51-54 obstructive sleep apnea, 55 renal disease, 56-58 psychiatric disease, 59 and bone loss 60 in patients with untreated aldosterone excess.…”

Section: Pathophysiology and Geneticsmentioning

confidence: 99%

Primary Aldosteronism

Galati

2015

Endocrinology and Metabolism Clinics of North America

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Gender differences in anxiety and depressive symptoms in patients with primary hyperaldosteronism: A cross-sectional study

Cited by 65 publications

References 69 publications

Genetic, Molecular and Clinical Determinants for the Involvement of Aldosterone and Its Receptors in Major Depression

Genetic, Molecular and Clinical Determinants for the Involvement of Aldosterone and Its Receptors in Major Depression

Primary Aldosteronism: Changing Definitions and New Concepts of Physiology and Pathophysiology Both Inside and Outside the Kidney

Primary Aldosteronism

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