Abstract 17612: Aldosterone/Renin Ratio is a Predictor of Cardiovascular Events in Patients with Essential Hypertension
Background: Aldosterone is thought to be a deleterious factor for end-organ damage in hypertensive patients. It remains unclear whether aldosterone activity can predict the prognosis of essential hypertension (EH). We investigated relationships between renin/aldosterone profile and cardiovascular (CV) events in a long-term follow-up design.
Subjects and Methods: In 76 patients with EH, who admitted to Hiroshima University Hospital during 1985–1992, plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were determined while subjects were placed on 10g NaCl diet, then ratio of PAC to PRA (PAC/PRA) were calculated. The major CV events were observed for 18 ± 5.6 years. All patients were divided into two groups by 50-percentile; low-PAC/PRA (<64, n=38) group and high (≥64, n=38) group.
Results: Among all, 39% of patients (n=30) were already dead. There was no difference in the mean age, sex-distribution, blood pressure and other coronary risk factors between the two groups. The number of CV events (non-fatal and fatal) were 14 in the low-group and 23 in the high-group (36.8% vs. 60.5% p=0.038). The rate of total CV events was 2.0 per 100 patient years in the low group and 3.5 in the high group; rates of CV death were 0.9 and 1.4, respectively. Kaplan-Meier survival curve analysis revealed that the morbidity and mortality of CV events were significantly lower in the low group than in the high group (p=0.0014).
Conclusions: PAC/PRA, but not PAC, is an independent risk factor for CV events in patients with EH.
- © 2010 by American Heart Association, Inc.