This is a revised application to identify and study a large cohort of glucocorticoid remediable aldosteronism (GRA) patients. The spectrum of the severity and the natural history of the disorder will be characterized. The proposal seeks to determine modifying environmental and genetic factors which are important in regulation of blood pressure. Also, renal physiology will be studied in GRA patients to determine how these patients escape hypokalemia in spite of mineralocorticoid excess. There are four specific aims: 1) to determine the natural history and prevalence of GRA in various hypertensive populations, 2) to characterize the magnitude of effect imparted on blood pressure by inheritance of GRA and the sources of variation in phenotype expression of the hypertension, 3) to investigate the renal and hormonal mechanisms regulating potassium conservation and loss in GRA, and 4) to characterize the disequilibrium of GRA with Irish and Scottish descent and specific alleles of the aldosterone synthase gene.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
1R01HL053693-01A1
Application #
2231751
Study Section
Experimental Cardiovascular Sciences Study Section (ECS)
Project Start
1995-08-01
Project End
1999-07-31
Budget Start
1995-08-01
Budget End
1996-07-31
Support Year
1
Fiscal Year
1995
Total Cost
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Litchfield, W R; Anderson, B F; Weiss, R J et al. (1998) Intracranial aneurysm and hemorrhagic stroke in glucocorticoid-remediable aldosteronism. Hypertension 31:445-50
Litchfield, W R; Coolidge, C; Silva, P et al. (1997) Impaired potassium-stimulated aldosterone production: a possible explanation for normokalemic glucocorticoid-remediable aldosteronism. J Clin Endocrinol Metab 82:1507-10
Litchfield, W R; New, M I; Coolidge, C et al. (1997) Evaluation of the dexamethasone suppression test for the diagnosis of glucocorticoid-remediable aldosteronism. J Clin Endocrinol Metab 82:3570-3