Format

Send to

Choose Destination
Am J Hypertens. 2015 Jul;28(7):852-7. doi: 10.1093/ajh/hpu244. Epub 2014 Dec 26.

Aldosterone Levels, Aortic Stiffness, and Wave Reflection in Essential Hypertensive Patients.

Author information

1
Hypertension Unit, 1st Cardiology Clinic, Athens University, Hippokration Hospital, Athens, Greece;
2
Hypertension Unit, 1st Cardiology Clinic, Athens University, Hippokration Hospital, Athens, Greece; smkyvel@gmail.com.
3
1st Cardiology Clinic, Onassis Cardiosurgery Center, Athens, Greece;
4
Nephrology Department, Hippokration Hospital, Athens, Greece.

Abstract

BACKGROUND:

The aim of the present study was to evaluate the grade of arterial stiffening, in relation to aldosterone (ALDO) and plasma renin activity (PRA) levels, in essential never-treated hypertensive patients.

MATERIALS AND METHODS:

We studied 1,330 consecutive patients without clinical and/or laboratory findings of primary or secondary aldosteronism. Arterial stiffness indices Aix75 and carotid-femoral pulse wave velocity (PWVc-f) were measured and a 24-hour urine collection for ALDO was carried out to classify patients with low ALDO <12 mcg/24 hours and high ALDO >12 but <24 mcg/24 hours. Patients were divided according to PRA (high PRA > 1ng/ml/hour, low PRA < 1ng/ml/hour) and ALDO levels (high ALDO > 12 but <24 mcg/24 hours, low ALDO < 12 mcg/24 hours) in four groups. Also patients were grouped according to serum ALDO quartiles, 24-hour urine ALDO quartiles, PRA quartiles, and serum ALDO/PRA quartiles.

RESULTS:

Patients were classified in 4 groups: group I (high ALDO and low PRA), group II (high ALDO and high PRA), group III (low ALDO and low PRA), and finally group IV (low ALDO and high PRA). PWVc-f and AoAIx75 were significantly higher in group I followed by group II, III, and IV (P < 0.001). Comparison of arterial stiffness indices according to PRA quartiles and PWVc-f and AoAIx75 showed significantly higher in the 1st quartile compared to 2nd, 3rd, and 4th, respectively (P < 0.001). PWVc-f and AoAIx75 were also compared among the four quartiles of aldosterone-renin ratio and they were significantly higher (P < 0.001) in the 4th quartile followed by the 3rd, 2nd, and 1st, respectively.

CONCLUSIONS:

Arterial stiffness indices are higher among essential hypertensive patients with high normal serum and urine ALDO levels, pointing to a causal relationship between renin-angiotensin-aldosterone system activation and large artery properties.

KEYWORDS:

aldosterone; arterial stiffness; blood pressure; essential hypertension; hypertension; plasma renin activity.

PMID:
25542624
DOI:
10.1093/ajh/hpu244
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center