Department of Epidemiology and Public Health, University College London, London, UK.
J Hum Hypertens. 2011 Jul;25(7):437-43. doi: 10.1038/jhh.2010.82. Epub 2010 Aug 5.
The renin-angiotensin-aldosterone system can be activated by sympathetic nervous input and is thought to have an important role in the prevalence of hypertension and cardiovascular risk in black Africans. We examined (1) the association between plasma renin responses to mental stress and a marker of sub-clinical atherosclerosis; and (2) associations between resting renin and 24-h ambulatory blood pressure. Participants were 143 urbanized black African men and women (43.1 ± 7.7 years) drawn from a study of Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA). After an overnight fast, participants completed the Stroop mental stress task. Blood samples were drawn during baseline and 10 min after the task to assess the concentration of active renin in plasma. Blood pressure assessments included continuous Finometer measures during the stress testing and 24-h ambulatory monitoring. Carotid intima-media thickness (CIMT) was measured using high-resolution ultrasound. Approximately 50% of the sample responded to the task with an increase in renin concentration. Multiple linear regression analysis revealed an association between the renin stress response and CIMT (β = 0.024, 95% confidence interval, 0.004-0.043), after adjustment for conventional risk factors, blood pressure stress responses and basal levels of renin activity (R(2) for model = 0.37). In addition, resting renin was inversely associated with ambulatory blood pressure. In summary, heightened release of renin during a laboratory mental stressor was associated with a marker of sub-clinical atherosclerosis; thus, it may be a potential mechanism in explaining the increased burden of cardiovascular disease in urbanized black Africans.
肾素-血管紧张素-醛固酮系统可被交感神经输入激活，被认为在黑非洲人中高血压和心血管风险的流行中具有重要作用。我们研究了（1）精神应激时血浆肾素反应与亚临床动脉粥样硬化标志物之间的关系；以及（2）静息肾素与 24 小时动态血压之间的关系。参与者是从非洲交感神经活动和动态血压研究（SABPA）中抽取的 143 名城市化黑非洲男性和女性（43.1±7.7 岁）。在禁食过夜后，参与者完成了 Stroop 精神应激任务。在基线和任务后 10 分钟采血，以评估血浆中活性肾素的浓度。血压评估包括在应激测试期间的连续 Finometer 测量和 24 小时动态监测。颈动脉内膜中层厚度（CIMT）使用高分辨率超声测量。约有 50%的样本对任务作出反应，肾素浓度增加。多元线性回归分析显示，肾素应激反应与 CIMT 之间存在关联（β=0.024，95%置信区间，0.004-0.043），调整了常规危险因素、血压应激反应和基础肾素活性水平后（模型 R²=0.37）。此外，静息肾素与动态血压呈负相关。总之，实验室精神应激时肾素释放增加与亚临床动脉粥样硬化标志物有关；因此，它可能是解释城市化黑非洲人心血管疾病负担增加的潜在机制。
