Letter by Huzen et al Regarding Article, “Association of Leukocyte Telomere Length With Circulating Biomarkers of the Renin-Angiotensin-Aldosterone System: The Framingham Heart Study”
To the Editor:
We read with great interest the article titled “Association of Leukocyte Telomere Length With Circulating Biomarkers of the Renin-Angiotensin-Aldosterone System: The Framingham Heart Study” by Vasan et al.1 The authors conclude that leukocyte telomere length is shorter in individuals with a higher renin-to-aldosterone ratio (ie, a more active renin-angiotensin-aldosterone system), especially in hypertensive subjects. Surprisingly, the authors present only serum renin and aldosterone levels as biochemical indicators of the renin-angiotensin-aldosterone system; they also could have used some clinical proxies to further strengthen the concept of renin-angiotensin-aldosterone system activation (ie, blood pressure, left ventricular hypertrophy, B-type natriuretic peptide, incident heart failure, or other measures available in the Framingham Heart Study2). Instead of requesting confirmation of their findings, the authors themselves could have confirmed (or not) the findings of others suggesting a link of telomere length with activated renin-angiotensin-aldosterone system characteristics, including blood pressure measures and heart failure (or B-type natriuretic peptide as proxy).3–5
Vasan RS, Demissie S, Kimura M, Cupples LA, Rifai N, White C, Wang TJ, Gardner JP, Cao X, Benjamin EJ, Levy D, Aviv A. Association of leukocyte telomere length with circulating biomarkers of the renin-angiotensin-aldosterone system: the Framingham Heart Study. Circulation. 2008; 117: 1138–1144.
Kathiresan S, Gona P, Larson MG, Vita JA, Mitchell GF, Tofler GH, Levy D, Newton-Cheh C, Wang TJ, Benjamin EJ, Vasan RS. Cross-sectional relations of multiple biomarkers from distinct biological pathways to brachial artery endothelial function. Circulation. 2006; 113: 938–945.
Benetos A, Okuda K, Lajemi M, Kimura M, Thomas F, Skurnick J, Labat C, Bean K, Aviv A. Telomere length as an indicator of biological aging: the gender effect and relation with pulse pressure and pulse wave velocity. Hypertension. 2001; 37: 381–385.
Jeanclos E, Schork NJ, Kyvik KO, Kimura M, Skurnick JH, Aviv A. Telomere length inversely correlates with pulse pressure and is highly familial. Hypertension. 2000; 36: 195–200.