Plasma renin activity, serum aldosterone concentration and selected organ damage indices in essential arterial hypertension

Tomasz Pizoń; Marek Rajzer; Wiktoria Wojciechowska; Tomasz Drożdż; Dorota Drożdż; Marta Rojek; Krystian Gruszka; Danuta Czarnecka

doi:10.5114/aoms.2018.73333

Plasma renin activity, serum aldosterone concentration and selected organ damage indices in essential arterial hypertension

Arch Med Sci. 2018 Feb 7;17(1):9-18. doi: 10.5114/aoms.2018.73333. eCollection 2021.

Authors

Tomasz Pizoń¹, Marek Rajzer¹, Wiktoria Wojciechowska¹, Tomasz Drożdż¹, Dorota Drożdż², Marta Rojek¹, Krystian Gruszka¹, Danuta Czarnecka¹

Affiliations

¹ 1 Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland.
² Department of Pediatric Nephrology, Jagiellonian University Medical College, Krakow, Poland.

Abstract

Introduction: The aim of this study was to assess the relations between plasma renin activity (PRA), serum aldosterone concentration (ALDO) and selected asymptomatic organ damage (AOD) indices in mild primary arterial hypertension (AH).

Material and methods: We measured PRA, ALDO, and selected AOD indices (carotid-femoral pulse wave velocity (cfPWV), central aortic pulse pressure (cPP), estimated glomerular filtration rate (eGFR)) in 122 patients with untreated AH.

Results: Patients with high PRA (≥ 0.65 ng/ml/h) were characterized by lower plasma sodium and aldosterone to renin ratio (ARR), higher ALDO, but a similar level of AOD indices compared to patients with low PRA. cfPWV (p = 0.04) and cPP (p = 0.019) increased with ARR, while eGFR decreased with ALDO (p = 0.008). Only eGFR was independently correlated with ALDO. In subjects with simultaneously high PRA and ARR values, we found significantly higher cfPWV (p = 0.02) and cPP (p = 0.04) and lower eGFR (p = 0.02) than in those with high PRA but low ARR values.

Conclusions: Assessment of the influence of the renin-angiotensin-aldosterone system (RAAS) on AOD should include the relationship between renin and aldosterone. The PRA itself has no predictive value for AOD. More advanced arterial stiffness and renal impairment are associated with increased PRA and ARR. The RAAS activity might be useful in AOD prediction and hypertension severity assessment.

Keywords: aldosterone; asymptomatic organ damage; essential arterial hypertension; plasma renin activity; renin-angiotensin-aldosterone system.