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Plasma renin activity predicts cardiovascular mortality in the Heart Outcomes Prevention Evaluation (HOPE) study

Subodh Verma1, Milan Gupta, Daniel T Holmes

  • 1Division of Cardiac Surgery, Keenan Research Centre in the Li Ka Shing Knowledge Institute of St Michael's, University of Toronto, Ontario, Canada.

European Heart Journal
|March 19, 2011
PubMed

Insights

High plasma renin activity (PRA) independently predicts major vascular events and mortality in high-risk patients with stable vascular disease or diabetes. This suggests PRA may be a valuable risk marker and potential therapeutic target.

Area of Science:

  • Cardiology
  • Endocrinology
  • Vascular Medicine

Background:

  • Plasma renin activity (PRA) is a potential predictor of cardiovascular (CV) risk.
  • Limited large-scale prospective data exist for patients with stable vascular disease/diabetes without heart failure.

Purpose of the Study:

  • To evaluate PRA's predictive value for CV events and mortality.
  • To assess PRA as a marker in patients with stable chronic vascular disease and/or diabetes.

Main Methods:

  • Analysis of 2913 patients from the HOPE study with baseline PRA measurements.
  • Median follow-up of 4.5 years to record major vascular events and mortality.

Main Results:

  • The highest fifth of PRA distribution showed a hazard ratio (HR) of 1.38 for major vascular events (P=0.03).
  • The highest PRA group had an HR of 1.89 for CV death.
  • Associations remained significant after adjusting for clinical factors, medications, and biomarkers.

Conclusions:

  • High PRA is an independent predictor of vascular events and mortality in high-risk patients.
  • PRA may serve as a risk marker and potential therapeutic target in atherosclerosis and diabetes.
Abstract

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