Aldosterone/renin ratio determines peripheral and central blood pressure values over a broad range

• Verfasst von: Tomaschitz, Andreas [VerfasserIn]
• Verfasst von: März, Winfried [VerfasserIn]
• Verfasst von: Pilz, Stefan [VerfasserIn]
• Verfasst von: Ritz, Eberhard [VerfasserIn]
• Verfasst von: Scharnagl, Hubert [VerfasserIn]
• Verfasst von: Renner, Wilfried [VerfasserIn]
• Verfasst von: Boehm, Bernhard O. [VerfasserIn]
• Verfasst von: Fahrleitner-Pammer, Astrid [VerfasserIn]
• Verfasst von: Weihrauch, Gisela [VerfasserIn]
• Verfasst von: Dobnig, Harald [VerfasserIn]
• Titel: Aldosterone/renin ratio determines peripheral and central blood pressure values over a broad range
• Verf.angabe: Andreas Tomaschitz, MD, Winfried Maerz, MD, Stefan Pilz, MD, Eberhard Ritz, MD, Hubert Scharnagl, PHD, Wilfried Renner, PHD, Bernhard O. Boehm, MD, Astrid Fahrleitner-Pammer, MD, Gisela Weihrauch, MSC, Harald Dobnig, MD
• E-Jahr: 2010
• Jahr: 4 May 2010
• Umfang: 10 S.
• Fussnoten: Gesehen am 28.11.2023
• Titel Quelle: Enthalten in: American College of CardiologyJournal of the American College of Cardiology
• Ort Quelle: New York, NY : Elsevier, 1983
• Jahr Quelle: 2010
• Band/Heft Quelle: 55(2010), 19, Seite 2171-2180
• ISSN Quelle: 1558-3597
• DOI: doi:10.1016/j.jacc.2010.01.032
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: aldosterone
• Sach-SW: aldosterone/renin ratio
• Sach-SW: arterial blood pressure
• Sach-SW: hypertension
• Sach-SW: pathophysiology
• Sach-SW: renin
• K10plus-PPN: 1871440645

Abstract

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.