Parikh Nisha I, Gona Philimon, Larson Martin G, Wang Thomas J, Newton-Cheh Christopher, Levy Daniel, Benjamin Emelia J, Kannel William B, Vasan Ramachandran S
Framingham Heart Study, Boston University School of Medicine, 73 Mount Wayte Avenue, Suite 2, Framingham, MA 01702-5803, USA.
Eur Heart J. 2007 Nov;28(21):2644-52. doi: 10.1093/eurheartj/ehm399. Epub 2007 Sep 25.
Previous studies relating plasma renin to cardiovascular disease (CVD) and mortality yielded conflicting results. We related plasma renin to incidence of CVD and mortality in 3408 individuals (mean age 59; 53% women) and in a hypertensive subset (n = 1413).
On follow-up (mean 7.1 years), 176 participants (122 hypertensives) developed CVD and 215 individuals (127 hypertensives) died. Overall, log-renin was associated with mortality [multivariable-adjusted hazards ratio (HR) per SD increment: in whole sample, 1.14, 95% confidence interval (CI) 1.00-1.30, P = 0.046; hypertensives, 1.16, 95% CI 1.00-1.35, P = 0.046], but relations varied over time (P < 0.02). Log-renin was associated with mortality at 2.5 years of follow-up (HR per SD increment: whole sample at 2.5 years, 1.23, 95% CI 1.04-1.45; hypertensives at 2 years, 1.28, 95% CI 1.06-1.54), but not during longer follow-up (HR per SD increment at 5 years: whole sample, 1.02, 95% CI 0.80-1.29; hypertensives, 0.98, 95% CI 0.74-1.30). The time-dependent relation of renin and mortality risk was maintained upon excluding participants with prevalent CVD. Renin was not associated with CVD incidence (HR per SD increment log-renin: whole sample, 0.99, 95% CI 0.85-1.14; hypertensives, 0.96, 95% CI 0.82-1.12).
Higher plasma renin was associated with greater short-term mortality but not with CVD incidence in the community.
先前关于血浆肾素与心血管疾病（CVD）及死亡率关系的研究结果相互矛盾。我们研究了3408名个体（平均年龄59岁；53%为女性）及一个高血压亚组（n = 1413）中血浆肾素与CVD发病率及死亡率的关系。
在随访（平均7.1年）期间，176名参与者（122名高血压患者）发生了CVD，215名个体（127名高血压患者）死亡。总体而言，对数肾素与死亡率相关[每标准差增加的多变量调整风险比（HR）：在整个样本中，1.14，95%置信区间（CI）1.00 - 1.30，P = 0.046；高血压患者中，1.16，95% CI 1.00 - 1.35，P = 0.046]，但这种关系随时间变化（P < 0.02）。对数肾素在随访2.5年时与死亡率相关（每标准差增加的HR：整个样本在2.5年时，1.23，95% CI 1.04 - 1.45；高血压患者在2年时，1.28，95% CI 1.06 - 1.54），但在更长随访期间不相关（5年时每标准差增加的HR：整个样本，1.02，95% CI 0.80 - 1.29；高血压患者，0.98，95% CI 0.74 - 1.30）。排除患有CVD的参与者后，肾素与死亡风险的时间依赖性关系依然存在。肾素与CVD发病率无关（每对数肾素标准差增加的HR：整个样本，0.99，95% CI 0.85 - 1.14；高血压患者，0.96，95% CI 0.82 - 1.12）。
较高的血浆肾素与社区人群较高的短期死亡率相关，但与CVD发病率无关。
