Key result
High plasma renin and ARR in hypertension linked to greater arterial stiffness and lower eGFR.
Why the study?
Are plasma renin activity and serum aldosterone concentration associated with asymptomatic organ damage indices in patients with untreated mild primary arterial hypertension?
Cross-Sectional (n=122)
No
Are plasma renin activity and serum aldosterone concentration associated with asymptomatic organ damage indices in patients with untreated mild primary arterial hypertension?
Absolute Event Rate: 10% vs 8%
p-value: p=0.02
In untreated mild primary arterial hypertension, increased aldosterone-to-renin ratio and aldosterone levels, rather than plasma renin activity alone, are associated with more advanced arterial stiffness and renal impairment.
High ARR associates with stiffness and lower eGFR in untreated hypertension; hypothesis-generating, needs prospective trials before any clinical use.
Introduction The aim of this study was to assess the relations between plasma renin activity (PRA), serum aldosterone concentration (ALDO) and selected asymptomatic organ damage (AOD) indices in mild primary arterial hypertension (AH). Material and Methods We measured PRA, ALDO, and selected AOD indices (carotid-femoral pulse wave velocity (cfPWV), central aortic pulse pressure (cPP), estimated glomerular filtration rate (eGFR)) in 122 patients with untreated AH. Results Patients with high PRA (≥ 0.65 ng/ml/h) were characterized by lower plasma sodium and aldosterone to renin ratio (ARR), higher ALDO, but a similar level of AOD indices compared to patients with low PRA. cfPWV (p = 0.04) and cPP (p = 0.019) increased with ARR, while eGFR decreased with ALDO (p = 0.008). Only eGFR was independently correlated with ALDO. In subjects with simultaneously high PRA and ARR values, we found significantly higher cfPWV (p = 0.02) and cPP (p = 0.04) and lower eGFR (p = 0.02) than in those with high PRA but low ARR values. Conclusions Assessment of the influence of the renin-angiotensin-aldosterone system (RAAS) on AOD should include the relationship between renin and aldosterone. The PRA itself has no predictive value for AOD. More advanced arterial stiffness and renal impairment are associated with increased PRA and ARR. The RAAS activity might be useful in AOD prediction and hypertension severity assessment.
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Pizon et al. (2018) conducted a cross-sectional in Essential arterial hypertension (n=122). High plasma renin activity (≥0.65 ng/ml/h) and high aldosterone-to-renin ratio (≥18.42) vs. High plasma renin activity (≥0.65 ng/ml/h) and low aldosterone-to-renin ratio (<18.42) was evaluated on Carotid-femoral pulse wave velocity (cfPWV) (p=0.02). Patients with essential hypertension and simultaneously high plasma renin activity and aldosterone-to-renin ratio had significantly higher arterial stiffness and lower estimated glomerular filtration rate.
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