Níveis elevados de aldosterona sérica em indivíduos com psoríase e hipertensão arterial sistêmica

Abstract

Background: Epidemiological studies suggest a higher prevalence of systemic arterial hypertension (HTN) and other cardiovascular diseases in patients with psoriasis. The underlying mechanism remains unclear, but may involve activation of the renin-angiotensin-aldosterone system (RAAS). This study aimed to compare renin and aldosterone levels between psoriasis patients and non-psoriasis individuals. Methods: A prospective, cross-sectional study enrolled consecutive patients from a university hospital’s dermatology outpatient clinic. Clinical evaluation was followed by blood collection for renin and aldosterone measurement, allowing for comparison between psoriasis and non-psoriasis patients. Subgroup analyses stratified participants based on HTN presence. Multiple linear regression analyses identified independent predictors of higher renin and aldosterone levels. Results: The study included 17 patients (mean age: 55 ± 13 years, 50.6% men, 85.9% non-white), with 57,6% having psoriasis and 44.1% with HTN. Mean plasma renin levels were similar in psoriasis and non-psoriasis patients (26.3 ± 51.4 versus 23.9 ± 48.7 µUI/ml, respectively, p = 0.764). However, psoriasis patients showed significantly higher mean serum aldosterone levels (25.3 ± 49.4 versus 11.7 ± 10.7 ng/dl, p = 0.009). Stratification revealed that only psoriasis patients with HTN had significantly higher aldosterone levels compared to other subgroups. In multiple linear regression analyses, psoriasis was only associated with higher levels of aldosterone in hypertensive patients. Conclusions: This study indicates elevated serum aldosterone levels in patients with both psoriasis and HTN. Further investigation is necessary to understand the potential impact of this finding on cardiovascular morbidity and mortality in psoriasis patients.