Copeptin is increased in resistant hypertension
Abstract
OBJECTIVES: The participation of vasopressin in the mechanisms of resistant hypertension is unclear. We compared plasma copeptin concentration, a surrogate marker for vasopressin secretion, between patients with resistant hypertension and those with controlled blood pressure (CBP), in a post hoc analysis of the Prise en charge de l'Hypertension Artérielle RESistante au traitement trial. METHODS: After 4-week treatment with irbesartan 300 mg/day, hydrochlorothiazide 12.5 mg/day, and amlodipine 5 mg/day (baseline), 166 patients were classified as having resistant hypertension (n = 140) or CBP (n = 26) by ambulatory BP monitoring. Patients with resistant hypertension were then randomized for 12 weeks of sequential nephron blockade (n = 74) or sequential renin-angiotensin system blockade (n = 66). Plasma copeptin concentration was measured at baseline and week 12 by immunoassay. RESULTS: Baseline plasma copeptin concentration was positively associated with male sex, plasma osmolality, BP, and negatively with glomerular filtration rate. It was higher in the resistant hypertension than in the CBP group [geometric mean 5.7 (confidence interval 95% 5.1-6.4) vs. 2.9 (2.3-3.9) fmol/ml, adjusted P < 0.0001). The relationship between plasma copeptin concentration and urinary osmolality was similar in the two groups. At 12 weeks, plasma copeptin concentration in patients whose BP was controlled by sequential nephron blockade or sequential renin-angiotensin system blockade [6.8 (5.6-8.2) and 4.3 (3.0-5.9) fmol/ml, respectively) remained significantly higher than in patients with CBP at baseline (P < 0.0001 vs. both). CONCLUSION: In patients with resistant hypertension, plasma copeptin concentrations were approximately two-fold higher than those of patients with CBP, after adjustment for plasma osmolality. This difference was not accounted for by renal resistance to vasopressin, suggesting a primary reset of osmostat.
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Plasma osmolality-adjusted copeptin concentrations, a surrogate marker for vasopressin release, are almost twice as high in individuals with resistant hypertension compared with those with nonresistant, controlled blood pressure.
“Plasma osmolality-adjusted copeptin concentrations, a surrogate marker for vasopressin release, are almost twice as high in individuals with RH compared with those with nonresistant, controlled BP.59”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [59]
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- Authors
- Mendes, M., Dubourg, J., Blanchard, A., Bergerot, D., Courand, P.-Y., Forni, V., Frank, M., Bobrie, G., Menard, J., & Azizi, M.
- Affiliations
- Inserm (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Corresponding author
- Blanchard, Anne
- Venue
- Journal of Hypertension
- Published
- 2016-12
- Volume
- 34
- Issue
- 12
- Pages
- 2458-2464
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W2530977102
- Cited by
- 22
- References
- 26
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 2
- FWCI
- 2.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- NIH Clinical Center
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
- Keywords
- resistant hypertension, copeptin, vasopressin, plasma osmolality, renin-angiotensin system blockade, irbesartan, hydrochlorothiazide, amlodipine, blood pressure control
- MeSH terms
- Irbesartan, Adult, Aged, Antihypertensive Agents, Biphenyl Compounds, Blood Pressure, Coronary Vasospasm, Diuretics, Female, Glomerular Filtration Rate, Glycopeptides, Humans, Hydrochlorothiazide, Hypertension, Male, Middle Aged, Nephrons, Osmolar Concentration, Renin-Angiotensin System, Sex Factors, Tetrazoles, Vasopressins, Biomarkers, Amlodipine
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