Key result
Patients with isolated systolic hypertension had significantly lower plasma renin activity and higher aldosterone/renin ratios (134.1 vs 42.2; p<0.001) than those with essential hypertension.
Why the study?
Are plasma renin activity and aldosterone/renin ratio altered in patients with untreated isolated systolic hypertension compared to essential hypertension and normal controls?
Cross-Sectional (n=101)
Are plasma renin activity and aldosterone/renin ratio altered in patients with untreated isolated systolic hypertension compared to essential hypertension and normal controls?
Patients with isolated systolic hypertension exhibit lower plasma renin activity and higher aldosterone/renin ratios, indicating relative aldosterone excess that may warrant targeted therapy.
Answers are grounded in this paper and cite their sources.
May support aldosterone-focused evaluation in isolated systolic hypertension; leaves open whether renin profiling improves outcomes in prospective trials.
OBJECTIVE: Isolated systolic hypertension (ISH) is generally encountered in elderly patients and there are scarce data regarding the renin-angiotensin-aldosterone system (RAAS) activity in patients with ISH. We aimed to determine the plasma renin activity (PRA), plasma aldosterone levels (PAL) and aldosterone/PRA ratio (PAL/PRA) in patients (age >50 years) with ISH and to compare these values with patients with essential hypertension (EH) as well as subjects with normal blood pressure values (control) who have similar age and cardiovascular risk profile. METHODS: Consecutively, 42 untreated ISH patients, 30 patients with EH and 29 normal subjects were included in the study. Parameters were presented as median (interquartile range). RESULTS: There were no significant differences regarding age, gender and other cardiovascular risk factors among groups. As expected, systolic, diastolic blood pressure and pulse pressure values were significantly different among groups. Besides, PRA values were found to be significantly lower in patients with ISH (0.4 [0.2-1.1] ng/ml/h) compared with the EH (0.95 [0.5-2.6] ng/ml/h, p =0.024) and control (1.3 [0.7-2.1] ng/ml/h, p =0.001) groups. Although, PAL were similar among groups, PAL/PRA ratio was significantly higher in ISH group (134.1 [73-224]) compared with those with EH (42.2 [35-84], p <0.001) and the control group (53.3 [30-106], p =0.001). No significant difference was present with respect to PAL/PRA ratio between EH and control groups. CONCLUSIONS: Our findings suggested that in patients with ISH, despite lower PRA levels, PAL/PRA ratio is significantly higher compared with the patients with EH and subjects with normal blood pressure. Since higher PAL/PRA levels is an indicator of relative aldosterone excess, medications blocking RAAS activity including aldosterone antagonists may have useful cardiovascular consequences in addition to their antihypertensive effects in ISH.
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Durukan et al. (2012) conducted a cross-sectional in Isolated systolic hypertension (n=101). Isolated systolic hypertension vs. Essential hypertension and normal blood pressure was evaluated on Plasma renin activity (PRA) and aldosterone/PRA ratio (PAL/PRA) (p=<0.001). Patients with isolated systolic hypertension had significantly lower plasma renin activity and higher aldosterone/renin ratios (134.1 vs 42.2; p<0.001) than those with essential hypertension.
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