Plasma renin and outcome in the community: data from PREVEND
Plasma renin and outcome in the community: data from PREVEND
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DOI：
10.1093/eurheartj/ehs198
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发表时间：
2012-09-01
影响因子：
39.3
通讯作者：
Hillege, Hans L.
中科院分区：
文献类型：
--
作者：
de Boer, Rudolf A.;Schroten, Nicolas F.;Hillege, Hans L.
肾素血管紧张素系统在已确诊的心血管（CV）疾病患者中起核心作用，但血浆肾素在社区中的预后作用尚不清楚。血浆肾素浓度与CV事件的关系在6228名未使用抗高血压药物的受试者中进行了研究，这些受试者参加了预防肾脏和血管终末期疾病（PREVEND）研究。血浆肾素浓度采用直接自动免疫化学发光法测定。平均（SD）年龄47（12）岁，男性49例；平均随访时间为10.5年。血浆肾素中位数（Q1Q3）为17.6 (10.927.2)IU/mL，血浆醛固酮为119 (93153)ng/L。主要结局是致命（27例）和非致命（408例）CV事件的综合结果。经年龄和性别调整后，血浆肾素每增加一倍与主要结局的危险比（HR）相关，为1.22 （95 CI: 1.041.43; P 0.015）。在多变量模型中，血浆肾素与心率和男性性别呈正相关，与血压、尿钠、葡萄糖和n端前b型钠肽（NT-pro-BNP）呈负相关（校正R-2: 0.167, P 0.001）。调整与血浆肾素相关的协变量后，达到主要结局的HR为1.28 （95 CI: 1.091.49, P 0.002）。血浆肾素与心血管事件相关，与血压无关，但在使用抗高血压药物的受试者中，这种关联不存在。血浆肾素浓度与未使用抗高血压药物的社区队列心血管事件风险增加相关。
The reninangiotensin system plays a central role in patients with established cardiovascular (CV) disease, but the prognostic effect of plasma renin in the community is unclear.The relationship between plasma renin concentration and CV events was studied in 6228 subjects who were enrolled in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study, and who were not using antihypertensive medication. Plasma renin concentration was measured using a direct automated immunochemiluminescent assay. The mean (SD) age was 47(12) years, 49 were male; the mean follow-up was 10.5 years. The median (Q1Q3) plasma renin was 17.6 (10.927.2) IU/mL, and plasma aldosterone was 119 (93153) ng/L. The primary outcome was a composite of fatal (n 27) and non-fatal (n 408) CV events. Adjusted for age and sex each doubling of plasma renin was associated with a hazard ratio (HR) for the primary outcome of 1.22 (95 CI: 1.041.43; P 0.015). In a multivariable model, plasma renin showed a positive correlation with heart rate and male sex and a negative correlation with blood pressure, urinary sodium, glucose, and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) (adjusted R-2: 0.167, P 0.001). After adjustment for covariates associated with plasma renin, the HR for reaching the primary outcome was 1.28 (95 CI: 1.091.49, P 0.002). Plasma renin was associated with CV events regardless of blood pressure, but in subjects using antihypertensive medication this association was absent.Plasma renin concentration is associated with an increased risk for CV events in a community-based cohort not on antihypertensive medication.