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End-organ damage in urbanized Africans with low plasma renin levels: the SABPA study

Johannes M van Rooyen1, Aletta E Schutte, Hugo W Huisman

  • 1Hypertension in Africa Research Team (HART), North-West University , Potchefstroom , South Africa.

Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|June 22, 2013
PubMed

Insights

Low active renin levels in urbanized Black South Africans are linked to sub-clinical renal damage and impaired vascular function. This association was specifically observed in the low-renin group, not the high-renin group.

Area of Science:

  • Cardiovascular Research
  • Nephrology
  • Human Physiology

Background:

  • The Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study investigates cardiovascular health in urbanized African populations.
  • Understanding the role of the renin-angiotensin-aldosterone system (RAAS) in cardiovascular and renal health is crucial, particularly in diverse ethnic groups.

Purpose of the Study:

  • To determine the association between active renin concentration and markers of end-organ damage in urbanized Africans.
  • To explore potential differences in these associations based on renin levels (low vs. high).

Main Methods:

  • Recruitment of 81 men and 74 women from an urbanized African population, categorized into low- and high-renin groups.
  • Comprehensive assessment including ambulatory blood pressure, ECG (Cornell voltage), Finometer cardiovascular monitoring, pulse wave velocity, carotid intima-media thickness (CIMT), and biochemical analyses (urinary creatinine, albumin, serum electrolytes).
  • High-sensitivity radio-immunometric assay used for plasma active renin concentration analysis.

Main Results:

  • A significant negative association (r=-0.29, p<0.01) was found between renal function (Albumin-to-Creatinine Ratio, ACR) and plasma renin concentration in the low-renin group (<6.18 pg/mL).
  • This negative association between renal function and plasma renin was not observed in the high-renin group.
  • Findings suggest a potential link between low renin levels and sub-clinical renal and vascular damage in this population.

Conclusions:

  • Low active renin concentration may be associated with sub-clinical renal damage and impaired vascular function in urbanized Black South Africans.
  • The observed association highlights the importance of renin levels in assessing cardiovascular and renal risk within specific ethnic groups.
  • Further research is warranted to elucidate the mechanisms underlying these findings and their clinical implications.

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