Cardiology Division, Department of Medicine, University Hospital of Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.
Cardiology Division, Department of Medicine, University Hospital of Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.
Am Heart J. 2020 Apr;222:199-207. doi: 10.1016/j.ahj.2019.11.022. Epub 2020 Jan 29.
The effect of the renin angiotensin system on blood pressure (BP) values in young adults from the general population is not well studied. We investigated the relationship between the aldosterone-to-renin ratio (ARR) and various BP indices in this population.
We assembled a population-based sample of adults aged 25-41 years. Conventional and 24-hour BP recordings were obtained in all patients. Direct renin concentration and plasma aldosterone concentration were measured. Multivariable regression models were constructed to assess the relationships of ARR with BP and hypertension.
We included 1,353 individuals (mean age 37 years, 56% women). The median (interquartile range) ARR, direct renin concentration, and plasma aldosterone concentration were 13.8 (8.7-22.9), 7.2 ng/L (4.4-11.0) and 94 ng/L (68-134). All BP indices were higher across sex-specific ARR quartiles. Per 1-unit increase in log-transformed ARR, the multivariable-adjusted β-coefficients (95% CI) for conventional, 24-hour, daytime, and nighttime systolic BP were 1.68 (0.87-2.48), P < .0001; 2.40 (1.68-3.12), P < .0001; 2.23 (1.48-2.99), P < .0001; and 2.80 (2.03-3.58), P < .0001, respectively. Per 1-unit increase in log-transformed ARR, the multivariable-adjusted odds ratio (95% CI) for conventional, 24-hour, sustained and masked hypertension was 1.70 (1.17-2.28), P = .0004; 1.29 (1.06-1.56), P = .01; 1.82 (1.33-2.49), P = .002; and 1.14 (0.94-1.38), P = .20, respectively.
In young adults, ARR was strongly associated with conventional and ambulatory BP. Our data suggest that an aldosterone-driven phenomenon occurs very early in the development of hypertension.
肾素-血管紧张素系统对普通人群中青年人群血压（BP）值的影响尚未得到充分研究。我们在该人群中研究了醛固酮与肾素比值（ARR）与各种 BP 指数之间的关系。
我们组建了一个 25-41 岁成年人的基于人群的样本。对所有患者进行常规和 24 小时 BP 记录。测量直接肾素浓度和血浆醛固酮浓度。构建多变量回归模型以评估 ARR 与 BP 和高血压的关系。
我们纳入了 1353 名个体（平均年龄 37 岁，56%为女性）。ARR、直接肾素浓度和血浆醛固酮浓度的中位数（四分位距）分别为 13.8（8.7-22.9）、7.2ng/L（4.4-11.0）和 94ng/L（68-134）。ARR 四分位数内的所有 BP 指数均随性别而异。ARR 的对数转换后，多变量调整的β系数（95%CI）常规、24 小时、日间和夜间收缩压分别为 1.68（0.87-2.48）、2.40（1.68-3.12）、2.23（1.48-2.99）和 2.80（2.03-3.58），P<0.0001。ARR 的对数转换后，多变量调整的比值比（95%CI）常规、24 小时、持续性和隐匿性高血压分别为 1.70（1.17-2.28）、1.29（1.06-1.56）、1.82（1.33-2.49）和 1.14（0.94-1.38），P=0.004、0.01、0.002 和 0.20。
在年轻人中，ARR 与常规和动态 BP 密切相关。我们的数据表明，醛固酮驱动的现象在高血压的早期就已经发生。
