Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
Hypertens Res. 2011 Mar;34(3):361-6. doi: 10.1038/hr.2010.236. Epub 2010 Dec 2.
Aldosterone-to-renin ratio (ARR) is used to screen primary hyperaldosteronism. We investigated the association between ARR and the prevalence of hypertension using home blood pressure (HBP) measurements in community residents stratified for long-term habitual dietary sodium intake. We obtained HBP and conventional blood pressure (CBP) data for 514 participants aged ≥35 years not receiving antihypertensive treatment in the general population of Ohasama (mean age: 59.7±10.8 years; 71.2% women). A standardized method was used to calculate habitual sodium intake from a food-frequency questionnaire. The prevalence of HBP hypertension (≥135/85 mmHg) and CBP hypertension (≥140/90 mmHg) were 12.6 and 20.2%, respectively. The median plasma renin activity (PRA), plasma aldosterone concentration (PAC) and ARR were 1.1 ngml(-1)h(-1), 6.4 ng per 100 ml and 5.5 ng per 100 ml per ngml(-1)h(-1), respectively. After adjustment for possible confounding factors, each 1 s.d. increase in logARR was associated with the prevalence of HBP hypertension (odds ratio 1.37; P=0.04), but not with the prevalence of CBP hypertension (P=0.2). The association of ARR with HBP hypertension was strengthened for subjects with high sodium intake (greater than or equal to the median of 4822 mgday(-1)), whereas it became nonsignificant for those with low sodium intake (interaction P=0.03). Among subjects with high sodium intake, HBP hypertensives had significantly lower PRA than normotensives, despite no differences in PAC. In conclusion, relative aldosterone excess or low-renin hypertension may have an important role in HBP hypertension in the general population with high sodium intake.
醛固酮/肾素比值（ARR）用于筛查原发性醛固酮增多症。我们使用社区居民的家庭血压（HBP）测量值，对长期习惯性膳食钠摄入量分层，调查了 ARR 与高血压患病率之间的关系。我们从 Ohasama （平均年龄：59.7±10.8 岁；71.2%为女性）的一般人群中获得了 514 名未接受抗高血压治疗的年龄≥35 岁的 HBP 和常规血压（CBP）数据。使用标准化方法从食物频率问卷中计算习惯性钠摄入量。HBP 高血压（≥135/85mmHg）和 CBP 高血压（≥140/90mmHg）的患病率分别为 12.6%和 20.2%。中位血浆肾素活性（PRA）、血浆醛固酮浓度（PAC）和 ARR 分别为 1.1ngml(-1)h(-1)、6.4ng per 100ml 和 5.5ng per 100ml per ngml(-1)h(-1)。在调整可能的混杂因素后，logARR 每增加 1 个标准差与 HBP 高血压的患病率相关（比值比 1.37；P=0.04），但与 CBP 高血压的患病率无关（P=0.2）。ARR 与 HBP 高血压的相关性在高钠摄入（大于或等于中位数 4822mgday(-1)）的受试者中增强，而在低钠摄入的受试者中变得无统计学意义（交互作用 P=0.03）。在高钠摄入的受试者中，尽管 PAC 无差异，但 HBP 高血压患者的 PRA 显著低于血压正常者。总之，相对醛固酮过多或低肾素性高血压可能在高钠摄入的一般人群中 HBP 高血压中起重要作用。
