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Association between plasma renin activity and metabolic cardiovascular risk factors in essential hypertension
K Allikmets1, T Parik, R Teesalu
1Department of Cardiology, University of Tartu, Estonia.
Objectives:
To study the relationships between plasma renin activity and metabolic cardiovascular risk factors in patients with essential hypertension.
Subjects And Design:
Patients with uncomplicated essential hypertension (n = 36) with a diastolic blood pressure of 95-115 mmHg were studied. Assessment of plasma renin activity (PRA) related to urinary sodium excretion was used to define subgroups with high (n = 12), medium (n = 16) and low renin profiles (n = 8).
Main Outcome Measures:
Fasting plasma lipid levels were determined. Glucose, insulin and C-peptide responses to standard oral glucose tolerance test (OGTT) were measured.
Results:
Patients with high PRA had higher levels of plasma cholesterol (6.13 +/- 0.81 versus 4.67 +/- 0.7 mmol L-1, P < 0.05) and triglycerides (2.14 +/- 0.18 versus 0.98 +/- 0.13 mmol L-1, P < 0.05), than the low PRA group. HDL-cholesterol levels were lower in the high renin group than in the low renin group (1.05 +/- 0.04 versus 1.26 +/- 0.09 mmol L-1, P < 0.05). Insulin and C-peptide sums were higher in high PRA group (33.8 +/- 1.2 versus 25.1 +/- 0.9 and 2.6 +/- 0.3 versus 1.9 +/- 0.4 ng L-1, P < 0.05), than in the low PRA group.
Conclusions:
Essential hypertensive patients with a high renin profile display more pronounced dyslipidaemia and higher levels of plasma insulin than patients with a low renin profile. This may be one explanation for higher incidence of cardiovascular disease previously reported in high PRA group.