Lim P O, Donnan P T, MacDonald T M
Department of Cardiology, Wales Heart Research Institute, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, Wales, UK.
J Hum Hypertens. 2001 Feb;15(2):119-23. doi: 10.1038/sj.jhh.1001138.
Aldosterone to renin ratio (ARR) is a marker of inappropriate aldosterone activity in hypertension. Since aldosterone may adversely affect vascular compliance, we hypothesised that the ARR would relate to exercise blood pressure (BP) responses in hypertension. Blood sampling was done in untreated hypertensives for plasma renin activity (PRA, ng/mL/hr) and plasma aldosterone (PA, pmol/L). ARR was derived by dividing the PA value by the PRA value, and this index was normalised by natural logarithm (lnARR) for further analyses. Each patient underwent 24-h ambulatory BP (ABP), and a 3-min submaximal exercise test using the Dundee Step Test. The Spearman rank correlation coefficients between lnARR and office BP (OBP), ABP and exercise BPs and BP changes estimated during exercise were assessed. A total of 119 (66 males) hypertensive subjects aged 48 (s.d. 12) years were studied. The respective OBP, ABP, exercise BP and the change in exercise BP were 167(23)/105(11), 140(15)/87(10), 189(26)/107(12) and 25(15)/2(9) mmHg. lnARR was significantly correlated with exercise systolic BP (r = 0.24, P < 0.001), exercise diastolic bp (r = 0.23, P < 0.05), systolic abp (r = 0.22, P < 0.05) and systolic obp (r = 0.19, P < 0.05). in a multiple regressional analysis controlling for age and sex and all other bp measurements to assess the relative strengths of correlation between all the bp indices with lnarr, only exercise systolic bp (P = 0.012) and the change in systolic BP during exercise (negatively, P = 0.013) emerged as significant independent predictors of lnARR. In conclusion, there was an independent and significant correlation between ARR and exercise systolic BP.
醛固酮与肾素比值（ARR）是高血压中醛固酮活性异常的一个标志物。由于醛固酮可能对血管顺应性产生不利影响，我们推测ARR与高血压患者运动血压（BP）反应相关。对未经治疗的高血压患者进行血样采集，以测定血浆肾素活性（PRA，ng/mL/小时）和血浆醛固酮（PA，pmol/L）。ARR通过将PA值除以PRA值得出，该指数经自然对数转换（lnARR）后用于进一步分析。每位患者均接受24小时动态血压监测（ABP），并使用邓迪阶梯试验进行3分钟次极量运动试验。评估lnARR与诊室血压（OBP）、ABP、运动血压以及运动期间估计的血压变化之间的斯皮尔曼等级相关系数。共研究了119名（66名男性）年龄为48（标准差12）岁的高血压受试者。各自的OBP、ABP、运动血压和运动血压变化分别为167(23)/105(11)、140(15)/87(10)、189(26)/107(12)和25(15)/2(9) mmHg。lnARR与运动收缩压（r = 0.24，P < 0.001）、运动舒张压（r = 0.23，P < 0.05）、收缩压ABP（r = 0.22，P < 0.05）和收缩压OBP（r = 0.19，P < 0.05）显著相关。在一项控制年龄、性别以及所有其他血压测量值的多元回归分析中，以评估所有血压指标与lnARR之间的相对相关强度，只有运动收缩压（P = 0.012）和运动期间收缩压变化（呈负相关，P = 0.013）是lnARR的显著独立预测因素。总之，ARR与运动收缩压之间存在独立且显著的相关性。
