Association of elevated plasma aldosterone-to-renin ratio with future cardiovascular events in patients with essential hypertension
Association of elevated plasma aldosterone-to-renin ratio with future cardiovascular events in patients with essential hypertension
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DOI：
10.1097/hjh.0b013e328359862d
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发表时间：
2012-12-01
影响因子：
4.9
通讯作者：
Kihara, Yasuki
中科院分区：
文献类型：
--
作者：
Kisaka, Tomohiko;Ozono, Ryoji;Kihara, Yasuki
背景：采用长期随访研究设计，对125例日本高血压病患者的血浆肾素活性(PRA)(ng/ml/h)、血浆醛固酮浓度(PAC)(ng/dl)、PAC/PRA比值[醛固酮/肾素比值(ARR)]进行测定，探讨其与预后的关系。根据ARR值相对于ARR值第50个百分位数的ARR将患者分为两组(ARR=5.5)：低ARR组(ARR 5.5，n=59)。结果：96例高血压病患者(占原始队列的77%)符合分析条件。平均随访18.6+/-5.2年。高ARR组的心血管发病率显著高于低ARR组，分别为3.2‰和2.4‰(经Kaplan-Meier分析，P=0.014)。在心血管事件中，高ARR组的中风发生率是低ARR组的2.7倍。通过COX比例风险模型分析，高ARR是心血管事件的独立危险标志。结论：高ARR是高血压患者心血管事件的独立危险标志。
Background: We investigated the relationship between the renin/aldosterone profiles of patients with essential hypertension and their prognosis using a long-term follow-up study design.Methods: The cohort consisted of 125 Japanese patients with essential hypertension whose plasma-renin activity (PRA) (ng/ml per h), plasma-aldosterone concentration (PAC) (ng/dl), and ratio of PAC to PRA [aldosterone-renin ratio (ARR)] were determined under hospitalization from 1984 to 1993. The patients were divided into two groups according to their ARRs relative to the 50th percentile of the ARR value (ARR = 5.5); the low-ARR group (ARR 5.5, n = 59). Their clinical outcomes were monitored during follow-up by the attending physicians.Results: Ninety-six patients with essential hypertension (77% of the original cohort) were eligible for the analyses. The mean follow-up time was 18.6 +/- 5.2 years. The cardiovascular morbidity was significantly higher in the high-ARR group than in the low-ARR group 3.2 vs. 2.4 per 100 patient-years, respectively (P = 0.014 by Kaplan-Meier analysis). Among the cardiovascular events, the incidence of stroke was 2.7-fold higher in the high-ARR group than in the low-ARR group. High ARR was an independent risk marker for cardiovascular events by Cox proportional hazards model analysis.Conclusion: High ARR was an independent risk marker for cardiovascular events in patients with essential hypertension.