High Plasma Renin and Aldosterone Levels Are Associated With a Unique Phenotype in Primary Hypertension

Area of Science:

• Endocrinology
• Nephrology
• Cardiovascular Medicine

Background:

• Primary hypertension is a heterogeneous condition.
• Subgrouping based on hormonal profiles, like renin and aldosterone, is crucial for understanding disease mechanisms.
• Low-renin hypertension is a recognized phenotype, but high-renin and high-aldosterone phenotypes require further investigation.

Purpose of the Study:

• To explore the clinical phenotype of untreated primary hypertension patients with high renin and aldosterone levels.
• To identify predictors and associated conditions within this specific hypertensive subgroup.
• To emphasize the clinical utility of stratifying hypertensive phenotypes for personalized medicine.

Main Methods:

• A cohort of 747 untreated primary hypertension patients was analyzed.
• Patients were stratified into four groups based on plasma renin activity and plasma aldosterone concentration thresholds.
• Statistical analysis, including multinomial logistic regression, was used to identify predictors.

Main Results:

• High renin and aldosterone levels were independently predicted by younger age, higher pulse rates, and greater nighttime systolic blood pressure.
• Microalbuminuria was significantly more prevalent in the high renin and aldosterone group (25.5%).
• Elevated uric acid levels were also more common in this phenotype (5.5±1.4 mg/dL).

Conclusions:

• The high renin and aldosterone phenotype in primary hypertension is associated with specific clinical characteristics.
• These findings underscore the importance of identifying distinct hypertensive phenotypes.
• Personalized treatment approaches are essential for managing primary hypertension subgroups effectively.