NEUROHUMORAL MECHANISMS IN GERIATRIC HYPERTENSION: ROLE OF ALDOSTERONE

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The purpose of this study is to determine if increased levels of a hormone produced in the adrenal gland, aldosterone, plays a part in the increase in blood pressure that is common as people get older. The study is designed to test for interactions between aldosterone and other factors known to be important in high blood pressure in older people. These factors are stiffness of blood vessels, the activity of the sympathetic nervous system (the part of the nervous system that produces the chemical norepinephrine that controls heart rate and blood pressure), insulin, and a relaxing factor produced by blood vessels (nitric oxide). These systems will be tested at the beginning of the study, and again six months later following treatment with one of two medications that are used to treat hypertension. Men and women aged 60 to 80 years will be recruited. To begin the study, systolic blood pressure must be less than 180 (top number) and diastolic blood pressure must be less than 110 (bottom number). Subjects in this study will be randomly assigned (similar to using a coin flip) to take either spironolactone (this medication blocks the effects of aldosterone) or hydrochlorothizide (a diuretic or water pill). This study is important because it will provide new information about the actions of aldosterone that may lead to increased blood pressure in older people, and the potential benefits of treating high blood pressure using an aldosterone blocking medication.