Abstract
Background: Aldosterone-to-renin ratio (ARR) is an index for inappropriate aldosterone activity and salt sensitivity. We previously reported that elevated ARR might be associated with salt-sensitive hypertension. Because salt-sensitive hypertensive patients are reported to show a diminished nocturnal decline in blood pressure, we hypothesized that high ARR may be associated with diminished nocturnal decline in blood pressure (generally referred to as a 'nondipping' pattern), especially in individuals with high sodium intake. Methods: This study tested this hypothesis in 184 participants aged at least 55 years not receiving antihypertensive treatment in a general Japanese population (age: 67.6±6.9 years; 71.7% women). Results: Ambulatory blood pressure monitoring identified 63 (34.2%) participants with a nondipping pattern (nocturnal decline of SBP <10%). The median plasma renin activity (PRA), plasma aldosterone concentration (PAC), and ARR were 0.8 ng/ml per h, 8.3 ng/dl, and 8.7 ng/dl per (ng/ml per h), respectively. After adjustment for possible confounding factors, each 1SD increase in logARR was associated with the prevalence of nondipping pattern (odds ratio, 1.95; P=0.002). This association was observed in individuals in the highest tertile of 24-h urinary sodium excretion estimated from spot urine data (e24-hUNa; ≥179.6 mEq/day; P=0.01) but disappeared in those in the lowest tertile of e24-hUNa (<147.9 mEq/day; P=0.6). In those in the highest tertile of e24-hUNa, PRA was significantly lower in nondippers than in dippers (0.49 vs. 0.85 ng/ml per h) despite no differences in PAC. Conclusion: These results suggest that relative aldosterone excess might be related to a nondipping pattern of blood pressure, especially in individuals with high sodium intake.
| Original language | English |
|---|---|
| Pages (from-to) | 1940-1947 |
| Number of pages | 8 |
| Journal | Journal of hypertension |
| Volume | 29 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 2011 Oct 1 |
| Externally published | Yes |
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Keywords
- Aldosterone-to-renin ratio
- Nondipping pattern
- Relative aldosterone excess
- Salt-sensitive hypertension
- Sodium intake
ASJC Scopus subject areas
- Internal Medicine
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
Aldosterone-to-renin ratio and nocturnal blood pressure decline in a general population : The Ohasama study. / Satoh, Michihiro; Kikuya, Masahiro; Ohkubo, Takayoshi; Mori, Takefumi; Metoki, Hirohito; Hashimoto, Takanao; Hara, Azusa; Utsugi, Megumi T.; Hirose, Takuo; Obara, Taku; Inoue, Ryusuke; Asayama, Kei; Kanno, Atsuhiro; Totsune, Kazuhito; Hoshi, Haruhisa; Satoh, Hiroshi; Imai, Yutaka.
In: Journal of hypertension, Vol. 29, No. 10, 01.10.2011, p. 1940-1947.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Aldosterone-to-renin ratio and nocturnal blood pressure decline in a general population
T2 - The Ohasama study
AU - Satoh, Michihiro
AU - Kikuya, Masahiro
AU - Ohkubo, Takayoshi
AU - Mori, Takefumi
AU - Metoki, Hirohito
AU - Hashimoto, Takanao
AU - Hara, Azusa
AU - Utsugi, Megumi T.
AU - Hirose, Takuo
AU - Obara, Taku
AU - Inoue, Ryusuke
AU - Asayama, Kei
AU - Kanno, Atsuhiro
AU - Totsune, Kazuhito
AU - Hoshi, Haruhisa
AU - Satoh, Hiroshi
AU - Imai, Yutaka
PY - 2011/10/1
Y1 - 2011/10/1
N2 - Background: Aldosterone-to-renin ratio (ARR) is an index for inappropriate aldosterone activity and salt sensitivity. We previously reported that elevated ARR might be associated with salt-sensitive hypertension. Because salt-sensitive hypertensive patients are reported to show a diminished nocturnal decline in blood pressure, we hypothesized that high ARR may be associated with diminished nocturnal decline in blood pressure (generally referred to as a 'nondipping' pattern), especially in individuals with high sodium intake. Methods: This study tested this hypothesis in 184 participants aged at least 55 years not receiving antihypertensive treatment in a general Japanese population (age: 67.6±6.9 years; 71.7% women). Results: Ambulatory blood pressure monitoring identified 63 (34.2%) participants with a nondipping pattern (nocturnal decline of SBP <10%). The median plasma renin activity (PRA), plasma aldosterone concentration (PAC), and ARR were 0.8 ng/ml per h, 8.3 ng/dl, and 8.7 ng/dl per (ng/ml per h), respectively. After adjustment for possible confounding factors, each 1SD increase in logARR was associated with the prevalence of nondipping pattern (odds ratio, 1.95; P=0.002). This association was observed in individuals in the highest tertile of 24-h urinary sodium excretion estimated from spot urine data (e24-hUNa; ≥179.6 mEq/day; P=0.01) but disappeared in those in the lowest tertile of e24-hUNa (<147.9 mEq/day; P=0.6). In those in the highest tertile of e24-hUNa, PRA was significantly lower in nondippers than in dippers (0.49 vs. 0.85 ng/ml per h) despite no differences in PAC. Conclusion: These results suggest that relative aldosterone excess might be related to a nondipping pattern of blood pressure, especially in individuals with high sodium intake.
AB - Background: Aldosterone-to-renin ratio (ARR) is an index for inappropriate aldosterone activity and salt sensitivity. We previously reported that elevated ARR might be associated with salt-sensitive hypertension. Because salt-sensitive hypertensive patients are reported to show a diminished nocturnal decline in blood pressure, we hypothesized that high ARR may be associated with diminished nocturnal decline in blood pressure (generally referred to as a 'nondipping' pattern), especially in individuals with high sodium intake. Methods: This study tested this hypothesis in 184 participants aged at least 55 years not receiving antihypertensive treatment in a general Japanese population (age: 67.6±6.9 years; 71.7% women). Results: Ambulatory blood pressure monitoring identified 63 (34.2%) participants with a nondipping pattern (nocturnal decline of SBP <10%). The median plasma renin activity (PRA), plasma aldosterone concentration (PAC), and ARR were 0.8 ng/ml per h, 8.3 ng/dl, and 8.7 ng/dl per (ng/ml per h), respectively. After adjustment for possible confounding factors, each 1SD increase in logARR was associated with the prevalence of nondipping pattern (odds ratio, 1.95; P=0.002). This association was observed in individuals in the highest tertile of 24-h urinary sodium excretion estimated from spot urine data (e24-hUNa; ≥179.6 mEq/day; P=0.01) but disappeared in those in the lowest tertile of e24-hUNa (<147.9 mEq/day; P=0.6). In those in the highest tertile of e24-hUNa, PRA was significantly lower in nondippers than in dippers (0.49 vs. 0.85 ng/ml per h) despite no differences in PAC. Conclusion: These results suggest that relative aldosterone excess might be related to a nondipping pattern of blood pressure, especially in individuals with high sodium intake.
KW - Aldosterone-to-renin ratio
KW - Nondipping pattern
KW - Relative aldosterone excess
KW - Salt-sensitive hypertension
KW - Sodium intake
UR - http://www.scopus.com/inward/record.url?scp=84855988762&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84855988762&partnerID=8YFLogxK
U2 - 10.1097/HJH.0b013e32834ab46a
DO - 10.1097/HJH.0b013e32834ab46a
M3 - Article
C2 - 21841498
AN - SCOPUS:84855988762
VL - 29
SP - 1940
EP - 1947
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 0263-6352
IS - 10
ER -