What question did this study set out to answer?

October 4, 2012European Heart JournalOpen Access

Plasma renin levels: the lower the better in terms of cardiovascular risk?

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Why the study?

Are high plasma renin levels associated with increased cardiovascular morbidity and mortality independent of blood pressure in a general adult population?

Population

6,228 adults from a general urban western population, including both hyper- and normotensive subjects who…

Comparison

High plasma renin levels (evaluated by quintiles) vs Lower plasma renin levels

Design

Editorial

Follow-up

on average ~10 years

Authors

BWB. WaeberUniversity Hospital of Lausanne FFF. FeihlUniversity Hospital of Lausanne

Discussion

Member takes

Implication

This editorial highlights evidence that high plasma renin levels independently predict cardiovascular morbidity and mortality in the general population, suggesting a potential prognostic role and supporting the use of renin-angiotensin system blockers.

Key Points

To examine whether circulating plasma renin levels predict cardiovascular morbidity and mortality independently of blood pressure and sodium balance in the general population.
Evaluation of community-dwelling adults (N=6,228) including normotensive and hypertensive individuals followed for an average of approximately 10 years in the PREVEND study.
Stratification of participants by plasma renin concentration quintiles alongside assessments of 24-hour urinary sodium excretion and blood pressure.
Conducted a subgroup analysis in treated hypertensive participants (n=843) to assess treatment-related modulation of renin.
Elevated circulating plasma renin levels were significantly associated with increased cardiovascular morbidity and mortality after adjustment for traditional cardiovascular risk factors.
The association between plasma renin and cardiovascular risk remained robust independently of baseline blood pressure measurements and 24-hour sodium excretion levels.
Among treated hypertensive participants (n=843), plasma renin levels showed no significant association with cardiovascular outcomes, likely due to divergent pharmacological effects on renin secretion.

Structured PICO

Are high plasma renin levels associated with increased cardiovascular morbidity and mortality independent of blood pressure in a general adult population?

Population

6,228 adults from a general urban western population (all living in the same city), including both hyper- and normotensive subjects who had not incurred any cardiovascular complication such as stroke at the time of inclusion.

Intervention

High plasma renin levels (evaluated by quintiles)

Comparator

Lower plasma renin levels

Outcome

Cardiovascular morbidity and mortalityhard clinical

Limitations

Did not assay active renin and prorenin
In treated hypertensive participants (n=843), renin levels had no link to cardiovascular risk, possibly due to small sample size or confounding by antihypertensive agents

Cite This Study

Waeber et al. (2012) studied this question.

synapsesocial.com/papers/6a7dda1d629c956ef7ac87be https://doi.org/10.1093/eurheartj/ehs245

Topics

Women and heart disease

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Plasma renin levels: the lower the better in terms of cardiovascular risk?

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Plasma renin levels: the lower the better in terms of cardiovascular risk?

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

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Topics

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