Urine Haptoglobin and Haptoglobin-Related Protein Predict Response to Spironolactone in Patients With Resistant Hypertension



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Martín Lorenzo, Marta and Martínez, Paula J. and Baldán Martín, Montserrat and López, Juan A. and Mínguez, Pablo and Santiago Hernández, Aránzazu and Vázquez, Jesús and Segura, Julián and Ruiz Hurtado, Gema and Vivanco, Fernando and Barderas, María G. and Ruilope, Luis M and Alvarez-Llamas, Gloria (2019) Urine Haptoglobin and Haptoglobin-Related Protein Predict Response to Spironolactone in Patients With Resistant Hypertension. Hypertension, 73 (4). pp. 794-802. ISSN 1524-4563

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Official URL: https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.118.12242?rfr_dat=cr_pub%3Dpubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org


Resistant hypertension prevalence is progressively increasing, and prolonged exposure to suboptimal blood pressure control results in higher cardiovascular risk and end-organ damage. Among various antihypertensive agents, spironolactone seems the most effective choice to treat resistant hypertension once triple therapy including a diuretic fails. However success in blood pressure control is not guaranteed, adverse effects are not negligible, and no clinical tools are available to predict patient’s response. Complementary to our previous study of resistant hypertension metabolism, here we investigated urinary proteome changes with potential capacity to predict response to spironolactone. Twenty-nine resistant hypertensives were included. A prospective study was conducted and basal urine was collected before spironolactone administration. Patients were classified in responders or nonresponders in terms of blood pressure control. Protein quantitation was performed by liquid chromatography–mass spectrometry; ELISA and target mass spectrometry analysis were performed for confirmation. Among 3310 identified proteins, HP (haptoglobin) and HPR (haptoglobin-related protein) showed the most significant variations, with increased levels in nonresponders compared with responders before drug administration (variation rate, 5.98 and 7.83, respectively). Protein-coordinated responses were also evaluated by functional enrichment analysis, finding oxidative stress, chronic inflammatory response, blood coagulation, complement activation, and regulation of focal adhesions as physiopathological mechanisms in resistant hypertension. In conclusion, protein changes able to predict patients’ response to spironolactone in basal urine were here identified for the first time. These data, once further confirmed, will support clinical decisions on patients’ management while contributing to optimize the rate of control of resistant hypertensives with spironolactone.

Item Type:Article
Uncontrolled Keywords:Blood pressure, haptoglobin, human, proteomics, resistant hypertension, spironolactone
Subjects:Medical sciences > Biology > Molecular biology
Medical sciences > Biology > Biochemistry
ID Code:56862
Deposited On:30 Aug 2019 16:58
Last Modified:04 Sep 2019 18:21

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