TY - JOUR
T1 - Aldosterone-to-renin ratio and home blood pressure in subjects with higher and lower sodium intake
T2 - The Ohasama Study
AU - Satoh, Michihiro
AU - Kikuya, Masahiro
AU - Hara, Azusa
AU - Ohkubo, Takayoshi
AU - Mori, Takefumi
AU - Metoki, Hirohito
AU - Utsugi, Megumi T.
AU - Hirose, Takuo
AU - Obara, Taku
AU - Inoue, Ryusuke
AU - Asayama, Kei
AU - Totsune, Kazuhito
AU - Hoshi, Haruhisa
AU - Satoh, Hiroshi
AU - Imai, Yutaka
PY - 2011/3
Y1 - 2011/3
N2 - Aldosterone-to-renin ratio (ARR) is used to screen primary hyperaldosteronism. We investigated the association between ARR and the prevalence of hypertension using home blood pressure (HBP) measurements in community residents stratified for long-term habitual dietary sodium intake. We obtained HBP and conventional blood pressure (CBP) data for 514 participants aged >35 years not receiving antihypertensive treatment in the general population of Ohasama (mean age: 59.7±10.8 years; 71.2% women). A standardized method was used to calculate habitual sodium intake from a food-frequency questionnaire. The prevalence of HBP hypertension (>135/85 mm Hg) and CBP hypertension (>140/90 mm Hg) were 12.6 and 20.2%, respectively. The median plasma renin activity (PRA), plasma aldosterone concentration (PAC) and ARR were 1.1 ng ml-1 h-1, 6.4 ng per 100 ml and 5.5 ng per 100 ml per ng ml-1 h-1, respectively. After adjustment for possible confounding factors, each 1 s.d. increase in logARR was associated with the prevalence of HBP hypertension (odds ratio 1.37; P=0.04), but not with the prevalence of CBP hypertension (P=0.2). The association of ARR with HBP hypertension was strengthened for subjects with high sodium intake (greater than or equal to the median of 4822 mg day-1), whereas it became nonsignificant for those with low sodium intake (interaction P=0.03). Among subjects with high sodium intake, HBP hypertensives had significantly lower PRA than normotensives, despite no differences in PAC. In conclusion, relative aldosterone excess or low-renin hypertension may have an important role in HBP hypertension in the general population with high sodium intake.
AB - Aldosterone-to-renin ratio (ARR) is used to screen primary hyperaldosteronism. We investigated the association between ARR and the prevalence of hypertension using home blood pressure (HBP) measurements in community residents stratified for long-term habitual dietary sodium intake. We obtained HBP and conventional blood pressure (CBP) data for 514 participants aged >35 years not receiving antihypertensive treatment in the general population of Ohasama (mean age: 59.7±10.8 years; 71.2% women). A standardized method was used to calculate habitual sodium intake from a food-frequency questionnaire. The prevalence of HBP hypertension (>135/85 mm Hg) and CBP hypertension (>140/90 mm Hg) were 12.6 and 20.2%, respectively. The median plasma renin activity (PRA), plasma aldosterone concentration (PAC) and ARR were 1.1 ng ml-1 h-1, 6.4 ng per 100 ml and 5.5 ng per 100 ml per ng ml-1 h-1, respectively. After adjustment for possible confounding factors, each 1 s.d. increase in logARR was associated with the prevalence of HBP hypertension (odds ratio 1.37; P=0.04), but not with the prevalence of CBP hypertension (P=0.2). The association of ARR with HBP hypertension was strengthened for subjects with high sodium intake (greater than or equal to the median of 4822 mg day-1), whereas it became nonsignificant for those with low sodium intake (interaction P=0.03). Among subjects with high sodium intake, HBP hypertensives had significantly lower PRA than normotensives, despite no differences in PAC. In conclusion, relative aldosterone excess or low-renin hypertension may have an important role in HBP hypertension in the general population with high sodium intake.
KW - aldosterone excess
KW - aldosterone-to-renin ratio
KW - epidemiology
KW - low-renin hypertension
KW - sodium-sensitive hypertension
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U2 - 10.1038/hr.2010.236
DO - 10.1038/hr.2010.236
M3 - Article
C2 - 21124331
AN - SCOPUS:79952431604
VL - 34
SP - 361
EP - 366
JO - Hypertension Research
JF - Hypertension Research
SN - 0916-9636
IS - 3
ER -