The relationship between plasma renin activity and serum lipid profiles in patients with primary arterial...

Area of Science:

• Cardiology
• Endocrinology
• Biochemistry

Background:

• Primary arterial hypertension (AH) is a complex condition with varying clinical and biochemical profiles.
• Renin levels, specifically plasma renin activity (PRA), can stratify hypertensive patients into distinct subgroups.
• Understanding lipid profiles in relation to renin status is crucial for comprehensive AH management.

Purpose of the Study:

• To compare clinical and biochemical characteristics, focusing on serum lipids, between patients with low-renin and high-renin primary AH.
• To identify factors influencing lipid concentrations within these subgroups.
• To elucidate the relationship between renin levels and lipid parameters in different AH phenotypes.

Main Methods:

• Untreated Stage 1 AH patients were categorized into low-renin (PRA < 0.65 ng/mL/h) and high-renin (PRA ⩾ 0.65 ng/mL/h) groups.
• Office and 24-h ambulatory blood pressure, serum aldosterone, lipids, and biochemical markers were compared.
• Regression analysis was employed to assess factors determining lipid concentrations.

Main Results:

• High-renin AH patients (N=58) exhibited higher heart rate, lower serum sodium, and significantly elevated serum aldosterone, albumin, total protein, total cholesterol, and LDL-C compared to low-renin patients (N=39).
• The aldosterone-to-renin ratio was lower in the high-renin group.
• In univariate analysis, only PRA in the low-renin group showed a positive association with LDL-C, which persisted after adjustments.

Conclusions:

• High-renin primary AH is associated with elevated total and LDL cholesterol levels.
• The direct relationship between LDL-C and PRA was observed exclusively in patients with low-renin primary hypertension.
• These findings highlight distinct lipid profiles and renin-dependent associations in different AH subtypes.