Key result
A high aldosterone-to-renin ratio (>5.5) was associated with significantly higher cardiovascular morbidity compared to a low ratio (3.2 vs. 2.4 per 100 patient-years; P=0.014) over 18.6 years.
Why the study?
Does a high aldosterone-to-renin ratio predict future cardiovascular events in patients with essential hypertension?
Cohort (n=96)
Does a high aldosterone-to-renin ratio predict future cardiovascular events in patients with essential hypertension?
A high aldosterone-to-renin ratio is an independent risk marker for future cardiovascular events, particularly stroke, in patients with essential hypertension.
ARR may stratify CV risk in essential hypertension; leaves open whether ARR-targeted therapy improves outcomes.
BACKGROUND: We investigated the relationship between the renin/aldosterone profiles of patients with essential hypertension and their prognosis using a long-term follow-up study design. METHODS: The cohort consisted of 125 Japanese patients with essential hypertension whose plasma-renin activity (PRA) (ng/ml per h), plasma-aldosterone concentration (PAC) (ng/dl), and ratio of PAC to PRA [aldosterone-renin ratio (ARR)] were determined under hospitalization from 1984 to 1993. The patients were divided into two groups according to their ARRs relative to the 50th percentile of the ARR value (ARR = 5.5); the low-ARR group (ARR <5.5, n = 66) and high-ARR group (ARR > 5.5, n = 59). Their clinical outcomes were monitored during follow-up by the attending physicians. RESULTS: Ninety-six patients with essential hypertension (77% of the original cohort) were eligible for the analyses. The mean follow-up time was 18.6 ± 5.2 years. The cardiovascular morbidity was significantly higher in the high-ARR group than in the low-ARR group 3.2 vs. 2.4 per 100 patient-years, respectively (P = 0.014 by Kaplan-Meier analysis). Among the cardiovascular events, the incidence of stroke was 2.7-fold higher in the high-ARR group than in the low-ARR group. High ARR was an independent risk marker for cardiovascular events by Cox proportional hazards model analysis. CONCLUSION: : High ARR was an independent risk marker for cardiovascular events in patients with essential hypertension.
No takes yet. Share an insight, caveat, or question.
Kisaka et al. (2012) conducted a cohort in essential hypertension (n=96). High aldosterone-to-renin ratio (ARR > 5.5) vs. Low aldosterone-to-renin ratio (ARR < 5.5) was evaluated on cardiovascular morbidity (p=0.014). A high aldosterone-to-renin ratio (>5.5) was associated with significantly higher cardiovascular morbidity compared to a low ratio (3.2 vs. 2.4 per 100 patient-years; P=0.014) over 18.6 years.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: