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Is DHAS related to hypertension? Perhaps, but it is still impossible to be certain

Journal of Human Hypertension volume 25, pages 405–406 (2011)Cite this article

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Quantitatively, dehydroepiandrosterone sulphate (DHAS) is the most important adrenal androgen. However, it is a steroid that is rarely measured with the only usual indication being investigation of female hirsutism. There have been only a few small studies of the relationship between DHAS and hypertension with conflicting results, so the larger study reported by Carroll et al.1 represents a major increase in our knowledge relating to DHAS.

Of the 4182 men reported by Carroll, 1381 were identified as having hypertension of whom only 400 were taking anti-hypertensive therapy. This is important because therapeutic reduction of blood pressure could theoretically interfere with identification of associations between risk factors and overt disease. For example, amlodipine has been shown to increase DHAS concentrations.2 Carroll et al. showed that more subjects in the lowest tertile for DHAS had hypertension, which would be compatible with an amlodipine effect (that is, those without hypertension would be likely to be those on treatment, and therefore if they were treated with amlodipine could be expected to have increased DHAS) were it not for the fact that samples were collected in 1985 and amlodipine was not given FDA approval until 1992. Radioimmunoassays for steroids in the mid-1980s were not as accurate as mass spectrometric assays and tended to significantly overestimate cortisol concentrations,3 Equally the precision of these assays was poor. Despite this, the range of drugs used to treat hypertension was smaller in the mid-1980s and a smaller proportion of people were treated, so the drawbacks of early assays are to some extent mitigated by the more ‘natural’ state of the subjects.

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  1. Clinical Chemistry Department, Queen's Hospital, Staffordshire, UK

    T Reynolds

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Correspondence to T Reynolds.

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In the last 5 years, the author has received payment for lecturing, support to attend conferences and for participating in Advisory Boards from AstraZeneca, Genzyme, Merck-Sharp and Dohme, and Merck Pharma.

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Reynolds, T. Is DHAS related to hypertension? Perhaps, but it is still impossible to be certain. J Hum Hypertens 25, 405–406 (2011). https://doi.org/10.1038/jhh.2010.135

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