Polymorphisms of α-adducin and salt sensitivity in patients with essential hypertension

Daniele Cusi, Cristina Barlassina, Tiziana Azzani, Giorgio Casari, Lorena Citterio, Marcella Devoto, Nicola Glorioso, Chiara Lanzani, Paolo Manunta, Marco Righetti, Rodolfo Rivera, Paola Stella, Chiara Troffa, Laura Zagato, Giuseppe Bianchi

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Abnormalities in renal sodium transport may be involved in hypertension. Adducin, an α/β heterodimeric protein found in the renal tubule is thought to regulate ion transport through changes in the actin cytoskeleton. We investigated whether an α-adducin polymorphism (Gly 460 Trp) is involved in essential hypertension in two separate populations. Methods. Linkage analysis of three DNA markers at different distances from the α-adducin locus (20-2500 kb) was done in 137 hypertensive sibling-pairs. 477 hypertensive and 322 normotensive individuals were genotyped for the α-adducin polymorphism. The blood-pressure response to acute and chronic changes in sodium balance was studied in hypertensive individuals with and without the 460 Trp α-adducin allele. Findings. Significant linkage was found for all three markers in the sibling-pair study. The extra shared alleles (9.1%, 6.5%, and 4.7%) and the significance level for linkage (p = 0.0006, p = 0.0119, and p = 0.0211) both decreased with increasing distance from the α-adducin locus. There was a significant association between the 460 Trp mutation and hypertension (p = 0.0003). In the salt-sensitivity test, to assess the acute blood-pressure response to changes in body sodium in 86 hypertensive patients, the decrease in mean arterial pressure was greater in 65 patients who were heterozygous for the mutant allele (Gly/Trp) than in 21 wild-type homozygotes (Gly/Gly) (mean decrease 15.9 [SE 2.0] vs 7.4 [1.3] mm Hg; p = 0.001). Similarly, 21 heterozygous hypertensive patients showed a greater fall in mean arterial pressure in response to 2 months' treatment with hydrochlorothiazide than did 37 wild-type homozygous hypertensive patients (mean decrease 14.7 [2.2] vs 6.8 [1.4] mm Hg; p = 0.002). Interpretation. Our findings of significant linkage of the α-adducin locus to essential hypertension and greater sensitivity to changes in sodium balance among patients with the mutant allele suggest that α-adducin is associated with a salt-sensitive form of essential hypertension. We suggest the α-adducin polymorphism may hypertensive patients who will benefit from treatment or manoeuvres to reduce total body sodium.

Original languageEnglish
Pages (from-to)1353-1357
Number of pages5
JournalLancet
Volume349
Issue number9062
DOIs
Publication statusPublished - May 10 1997

ASJC Scopus subject areas

  • Medicine(all)

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