Abstract 10636: Elevated Plasma Aldosterone/Renin Ratio Is Associated with Future Stroke in Japanese Patients with Essential Hypertension
Background: We investigated the relationship among renin-aldosterone status, salt-sensitivity of blood pressure, and the prognosis of essential hypertension (EH).
Methods: The cohort consists of 125 Japanese patients with EH whose PRA (ng/mL/hr), PAC (pg/mL), a ratio of PAC to PRA (ARR), and salt-sensitivity (blood pressure response to 1 week high salt diet) were determined in a hospitalized condition during a period between 1984 and 1993. Their clinical outcomes were followed up by attended doctors. Patients were divided into two groups by fifty-percentile (ARR=55); low ARR group (n=66) and high ARR group (n=59). After excluding patients whose contact information was lost, data from 96 patients were analyzed.
Results: The analyzed cohort consists of 96 EH (77% of the original cohort) whose mean follow-up time of 18.6 ± 5.2 years. The CV morbidity (3.2 vs. 2.4 per 100 patients years in high ARR vs. low ARR group, p=0.014 by Kaplan-Meier analysis) and mortality (1.1 vs. 0.63) were both higher in high ARR group than low ARR group. Among the CV events, the incidence of stroke was 2.7-fold higher in the high ARR group than the low ARR group. Cox’s proportional-hazards model demonstrated high ARR was an independent risk factor for CV events. Salt sensitivity was significantly larger in high ARR group than in low ARR group.
Conclusions: High ARR is associated with salt sensitivity and is an independent risk factor for CV events in patients with EH.
- © 2011 by American Heart Association, Inc.