[The correlation between the carotid artery plaque and the change of aldosterone level related indexes during captopril challenge test]
1Department of Endocrinology, Bengbu First People's Hospital, Bengbu 233000, China.
Insights
Hypertension patients with carotid artery plaque showed altered aldosterone and renin activity responses during a captopril challenge test, indicating a potential link between these factors and plaque development.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Hypertension Research
Background:
- Carotid artery plaque is a significant indicator of cardiovascular risk.
- Hypertension is a major risk factor for atherosclerosis and cardiovascular events.
- The renin-angiotensin-aldosterone system (RAAS) plays a crucial role in blood pressure regulation and cardiovascular remodeling.
Purpose of the Study:
- To examine the relationship between carotid artery plaque and changes in plasma aldosterone, renin activity, and aldosterone-to-renin ratio (ARR) following a captopril challenge test in hypertensive patients.
- To identify potential biomarkers for carotid artery plaque presence in individuals with hypertension.
Main Methods:
- Eighty-three hypertensive patients underwent a captopril challenge test.
- Patients were categorized into a plaque group (n=57) and a no-plaque group (n=26) based on carotid artery duplex ultrasonography.
- Plasma aldosterone concentration, renin activity, and ARR were measured before and after captopril administration, and changes were analyzed between groups.
Main Results:
- The prevalence of carotid artery plaque was 68.67% in the study population.
- The plaque group was older and had lower apolipoprotein A1 levels compared to the no-plaque group (P<0.05).
- Patients with carotid plaque exhibited significantly different changes in aldosterone, renin activity, and ARR post-captopril challenge compared to those without plaque (P<0.05). Specifically, the plaque group showed higher aldosterone and renin activity differences and a lower ARR difference.
Conclusions:
- Carotid artery plaque is highly prevalent in hospitalized hypertensive patients.
- The changes in aldosterone and ARR following a captopril challenge test are independently associated with the presence of carotid artery plaque.
- These findings suggest that RAAS activity, as assessed by the captopril challenge test, may offer insights into the development of carotid atherosclerosis in hypertensive individuals.
Objective:
To investigate the correlation between the carotid artery plaque and the change of plasma aldosterone level related indexes during captopril challenge test.
Methods:
The patients with hypertension were enrolled as research objects and the captopril challenge test were carried out when they were hospitalized to screen the cause of hypertension. There were intact carotid artery duplex ultrasonography diagnostic data in them (83 cases). They were divided into the plaque group(57 cases) with carotid artery plaque and no plaque group( 26 cases) without carotid artery plaque according to the carotid artery duplex ultrasonography diagnostic data. The correlation between the carotid artery plaque and the changes of aldosterone concentration, renin activity and aldosterone to renin activity ratio(ARR) in two groups were analyzed.
Results:
The detection rate of carotid artery plaque was 68.67%. Compare with no plaque group, the patients in plaque group were elder and the level of apolipoprotein A1,(APOA1) was lower (all P＜0.05). The ARR difference value before and after captopril challenge test was lower ( P＜0.05).The aldosterone difference value and the renin activity difference value before and after captopril challenge test were higher in plaque group (all P＜0.05).The aldosterone difference value and the renin activity difference value were positive in plaque group and were negative in no plaque group. The difference value of the ARR was negative in plaque group and was positive in no plaque group. Logistic regression analysis showed that the age, the difference value of ARR and the aldosterone before and after captopril challenge test could be associated independently with carotid artery plaque occurrence after excluding gender difference and other factors.
Conclusion:
The detection rate of carotid artery plaque was high among hospitalized patients with hypertension, the difference value of ARR and the aldosterone before and after captopril challenge test could be associated independently with carotid artery plaque occurrence.
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