Pizoń Tomasz, Rajzer Marek, Wojciechowska Wiktoria, Wach-Pizoń Małgorzata, Drożdż Tomasz, Wróbel Katarzyna, Gruszka Krystian, Rojek Marta, Kameczura Tomasz, Jurczyszyn Artur, Kąkol Janusz, Czarnecka Danuta
1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland.
2 Department of Observational and Internal Medicine, University Hospital, Kraków, Poland.
J Renin Angiotensin Aldosterone Syst. 2018 Oct-Dec;19(4):1470320318810022. doi: 10.1177/1470320318810022.
: The aim of the study was to evaluate clinical and biochemical differences between patients with low-renin and high-renin primary arterial hypertension (AH), mainly in reference to serum lipids, and to identify factors determining lipid concentrations.
: In untreated patients with AH stage 1 we measured plasma renin activity (PRA) and subdivided the group into low-renin (PRA < 0.65 ng/mL/h) and high-renin (PRA ⩾ 0.65 ng/mL/h) AH. We compared office and 24-h ambulatory blood pressure, serum aldosterone, lipids and selected biochemical parameters between subgroups. Factors determining lipid concentration in both subgroups were assessed in regression analysis.
: Patients with high-renin hypertension ( N = 58) were characterized by higher heart rate ( p = 0.04), lower serum sodium ( p < 0.01) and aldosterone-to-renin ratio ( p < 0.01), and significantly higher serum aldosterone ( p = 0.03), albumin ( p < 0.01), total protein ( p < 0.01), total cholesterol ( p = 0.01) and low-density lipoprotein cholesterol (LDL-C) ( p = 0.04) than low-renin subjects ( N = 39). In univariate linear regression, only PRA in the low-renin group was in a positive relationship with LDL-C ( R = 0.15, β = 1.53 and p = 0.013); this association remained significant after adjustment for age, sex, and serum albumin and aldosterone concentrations.
: Higher serum levels of total and LDL-C characterized high-renin subjects, but the association between LDL-C level and PRA existed only in low-renin primary AH.
本研究的目的是评估低肾素和高肾素原发性高血压（AH）患者之间的临床和生化差异，主要涉及血脂，并确定决定血脂浓度的因素。
在未经治疗的1期AH患者中，我们测量了血浆肾素活性（PRA），并将该组患者分为低肾素（PRA<0.65 ng/mL/h）和高肾素（PRA⩾0.65 ng/mL/h）AH患者。我们比较了亚组之间的诊室血压和24小时动态血压、血清醛固酮、血脂及选定的生化参数。在回归分析中评估了决定两个亚组血脂浓度的因素。
高肾素高血压患者（N=58）的特征为心率较高（p=0.04）、血清钠较低（p<0.01）和醛固酮与肾素比值较低（p<0.01），且血清醛固酮（p=0.03）、白蛋白（p<0.01）、总蛋白（p<0.01）、总胆固醇（p=0.01）和低密度脂蛋白胆固醇（LDL-C）（p=0.04）显著高于低肾素患者（N=39）。在单变量线性回归中，仅低肾素组的PRA与LDL-C呈正相关（R=0.15，β=1.53，p=0.013）；在调整年龄、性别、血清白蛋白和醛固酮浓度后，这种关联仍然显著。
高肾素患者的血清总胆固醇和LDL-C水平较高，但LDL-C水平与PRA之间的关联仅存在于低肾素原发性AH中。
