Document Detail


Aldosterone/renin ratio determines peripheral and central blood pressure values over a broad range.
MedLine Citation:
PMID:  20447545     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: With the present analysis we intended to investigate the magnitude of the effect of relative aldosterone excess in predicting peripheral as well as aortic blood pressure levels in a well-characterized cohort of patients undergoing coronary angiography. BACKGROUND: The discussion on the relationship between aldosterone concentration and blood pressure has recently gone beyond the role of primary aldosteronism in the genesis of arterial hypertension. METHODS: Plasma aldosterone (pg/ml) and plasma renin concentration (pg/ml) were determined in 3,056 Caucasian patients (age 62.5 +/- 11 years; 31.9% women) scheduled for coronary angiography in a single tertiary care center. We formed sex-specific deciles (D) according to plasma aldosterone/renin concentration ratio (ARR) (pg/ml/pg/ml). RESULTS: Mean peripheral systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the entire cohort were 141 +/- 24 mm Hg and 81 +/- 11 mm Hg, respectively. Mean ARR was 10.2 +/- 15.7 in men and 14.4 +/- 19.9 in women (p < 0.0001). Median SBP and aortic SBP increased steadily and significantly from ARR D1 (126.8 mm Hg and 130.0 mm Hg, respectively) to D10 (151.0 mm Hg and 149.6 mm Hg, respectively; p < 0.0001 for both) after multivariate adjustment for age, sex, body mass index, renal function, antihypertensive medications, and various parameters potentially influencing BP. Adjusted median DBP and aortic DBP also increased significantly from 74.3 mm Hg and 66.5 mm Hg (D1) to 86.9 mm Hg and 76.7 mm Hg, respectively (D10) (p < 0.001 for both). In a multivariate stepwise regression model, ARR emerged as the second most significant independent predictor (after age) of mean SBP and as the most important predictor of mean DBP in this patient cohort. CONCLUSIONS: Our results: 1) underline that the ARR affects BP well below a cutoff used for screening for primary aldosteronism; and 2) illustrate the importance of the ARR in modulating BP over a much wider range than is currently appreciated.
Authors:
Andreas Tomaschitz; Winfried Maerz; Stefan Pilz; Eberhard Ritz; Hubert Scharnagl; Wilfried Renner; Bernhard O Boehm; Astrid Fahrleitner-Pammer; Gisela Weihrauch; Harald Dobnig
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  55     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-06-10     Revised Date:  2010-10-21    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2171-80     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
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MeSH Terms
Descriptor/Qualifier:
Aldosterone / blood*
Biological Markers / blood
Cohort Studies
Coronary Angiography
Cross-Sectional Studies
Female
Humans
Hyperaldosteronism / complications,  diagnosis*,  physiopathology
Hypertension / blood*,  diagnosis*,  etiology
Male
Middle Aged
Predictive Value of Tests
Renin / blood*
Renin-Angiotensin System / physiology*
Sex Factors
Chemical
Reg. No./Substance:
0/Biological Markers; 52-39-1/Aldosterone; EC 3.4.23.15/Renin
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2010 May 11;55(19):2181-2   [PMID:  20447546 ]
J Am Coll Cardiol. 2010 Oct 26;56(18):1514-5; author reply 1515-6   [PMID:  20951330 ]

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