Department of Chemistry and Biochemistry, New Mexico State University, Las Cruces, New Mexico, USA; Molecular Biology and Interdisciplinary Life Sciences Program, New Mexico State University, Las Cruces, New Mexico, USA.
Ionis Pharmaceuticals, Carlsbad, California, USA.
J Am Coll Cardiol. 2023 Apr 4;81(13):1248-1259. doi: 10.1016/j.jacc.2023.01.033.
Angiotensinogen is the proximal precursor of the angiotensin peptide hormones of the renin-angiotensin-aldosterone system (RAAS). Clinical trials are ongoing targeting angiotensinogen for the treatment of hypertension and heart failure. The epidemiology of angiotensinogen is not well defined, particularly its relationship to ethnicity, sex, and blood pressure (BP)/hypertension.
The authors sought to determine the relationship of circulating angiotensinogen levels to ethnicity, sex, BP, incident hypertension, and prevalent hypertension in a modern sex-balanced ethnically diverse cohort.
Plasma angiotensinogen levels were measured in 5,786 participants from the MESA (Multi-Ethnic Study of Atherosclerosis). Linear, logistic, and Cox proportional hazards models were utilized to examine the associations of angiotensinogen with BP, prevalent hypertension, and incident hypertension, respectively.
Angiotensinogen levels were significantly higher in females than males and differed across self-reported ethnicities with the ordering (from highest to lowest): White, Black, Hispanic, and Chinese adults. Higher levels were associated with higher BP and odds of prevalent hypertension, after adjusting for other risk factors. Equivalent relative differences in angiotensinogen were associated with greater differences in BP in males vs females. In males not taking RAAS-blocking medications, a standard deviation increment in log-angiotensinogen was associated with 2.61 mm Hg higher systolic BP (95% CI: 1.49-3.80), while in females the same increment in angiotensinogen was associated with 0.97 mm Hg higher systolic BP (95% CI: 0.30-1.65).
Significant differences in angiotensinogen levels are present between sexes and ethnicities. A positive association is present between levels and prevalent hypertension and BP, which differs between sexes.
血管紧张素原是肾素-血管紧张素-醛固酮系统（RAAS）中血管紧张素肽激素的近端前体。针对血管紧张素原治疗高血压和心力衰竭的临床试验正在进行中。血管紧张素原的流行病学尚未得到很好的定义，特别是其与种族、性别和血压（BP）/高血压的关系。
作者旨在确定循环血管紧张素原水平与种族、性别、BP、新发高血压和现患高血压在一个现代性别平衡、种族多样化的队列中的关系。
从 MESA（动脉粥样硬化的多民族研究）中测量了 5786 名参与者的血浆血管紧张素原水平。利用线性、逻辑和 Cox 比例风险模型分别检查了血管紧张素原与 BP、现患高血压和新发高血压的关系。
女性的血管紧张素原水平明显高于男性，且根据自我报告的种族有所不同，从高到低依次为：白种人、黑种人、西班牙裔和中国成年人。在调整其他危险因素后，更高的水平与更高的 BP 和现患高血压的几率相关。在未服用 RAAS 阻断药物的男性中，log-血管紧张素原的标准偏差增加与收缩压升高 2.61mmHg（95%CI：1.49-3.80）相关，而在女性中，相同的血管紧张素原增量与收缩压升高 0.97mmHg（95%CI：0.30-1.65）相关。
男女之间和种族之间存在血管紧张素原水平的显著差异。水平与现患高血压和 BP 之间存在正相关，且在性别之间存在差异。
