Key result
Higher aldosterone to active renin ratio linked to increased nocturnal systolic and diastolic blood pressure.
Observational (n=211)
Effect estimate: ß-coefficient 0.177 (systolic), 0.162 (diastolic)
p-value: p=0.017 (systolic), 0.027 (diastolic)
In treated hypertensive patients, the aldosterone to active renin ratio is significantly associated with nocturnal blood pressure, highlighting the potential role of aldosterone excess in nighttime blood pressure control.
Hypothesis-generating for aldosterone excess in nocturnal hypertension; prospective trials needed before clinical consideration.
High aldosterone levels are considered to play a key role in arterial hypertension. Data on the relationship between the aldosterone to active renin ratio (AARR), a quantity of aldosterone excess, and ambulatory blood pressure (BP) monitoring (ABPM) during the night are, however, sparse. Hypertensive patients were recruited from local outpatient clinics who underwent 24-hour urine collection and in parallel ABPM. Plasma aldosterone and renin concentrations were measured by radioimmunoassay. A total of 211 patients (age, 60.2±10.2 years; 51.9% female) with a mean systolic/diastolic ABPM value of 128.7±12.8/77.1±9.2 mm Hg were evaluated. In backwards linear regression analyses adjusted for age, sex, body mass index, smoking, glomerular filtration rate, hemoglobin A1c , N-terminal prohormone of brain natriuretic peptide, urinary sodium/potassium ratio, and ongoing antihypertensive medication, AARR was significantly associated with nocturnal systolic (ß-coefficient: 0.177; P=.017) and diastolic BP (ß-coefficient: 0.162; P=.027). In patients with arterial hypertension, a significant association between AARR and nighttime BP even after adjustment for a broad panel of confounders was found.
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Grübler et al. (2014) conducted an observational in Arterial hypertension (n=211). Aldosterone to active renin ratio (AARR) was evaluated on Nocturnal systolic and diastolic blood pressure (ß-coefficient 0.177 (systolic), 0.162 (diastolic), p=0.017 (systolic), 0.027 (diastolic)). The aldosterone to active renin ratio was significantly associated with nocturnal systolic (ß-coefficient 0.177; P=0.017) and diastolic blood pressure (ß-coefficient 0.162; P=0.027).
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