Aldosterone and left ventricular hypertrophy in Afro-Caribbean subjects with low renin hypertension.

Abstract

BACKGROUND:

Activity of the renin-angiotensin-aldosterone system is thought to play a major role in determining blood pressure (BP) and target organ damage such as left ventricular hypertrophy. In Afro-Caribbean subjects, however, hypertension tends to be more severe despite lower plasma renin activity. We investigated whether this might be due to a different relation between aldosterone and renin in Afro-Caribbean compared to white subjects.

METHODS:

Plasma aldosterone and renin activity were assessed in the morning after 15 min seated in 383 hypertensive subjects of Afro-Caribbean or white ethnicity (61% Afro-Caribbean, 83% on treatment) attending a hypertension clinic in London, UK. Left ventricular mass index (LVMI) was assessed by echocardiography in 276 subjects.

RESULTS:

Plasma renin activity was lower in Afro-Caribbean compared to white subjects (0.4 [0.3-1.0] v 1.4 [0.5-3.4] ng/mL/h, medians [interquartile range], P < .0001). Despite this, aldosterone was higher in Afro-Caribbean compared to white subjects (8.0 [6.1-12.6] v 7.4 [2.3-17.1] ng/dL, medians [interquartile range], P < .01). The LVMI corrected for sex and BP was higher in Afro-Caribbean than in white subjects. In Afro-Caribbean but not in white subjects LVMI was independently correlated with plasma aldosterone (standardized regression coefficient, beta= 0.25, P < .001).

CONCLUSIONS:

In Afro-Caribbean hypertensive subjects in London, plasma aldosterone is elevated despite lower renin and may contribute to increased severity of hypertension and left ventricular hypertrophy in Afro-Caribbean compared to white subjects.

• Authors: Andrew D Stewart, Sandrine C Millasseau, Mathew Dawes, Patricia A Kyd, John B Chambers, James M Ritter, Philip J Chowienczyk
• Journal: American journal of hypertension (Am J Hypertens) Vol. 19 Issue 1 Pg. 19-24 (Jan 2006) ISSN: 0895-7061 [Print] United States
• PMID: 16461185 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Aldosterone
• Renin

Topics

• Adult
• Aged
• Aldosterone (blood, physiology)
• Black People
• Blood Pressure
• Caribbean Region (ethnology)
• Echocardiography
• Female
• Humans
• Hypertension (blood, complications, ethnology, physiopathology)
• Hypertrophy, Left Ventricular (blood, ethnology, etiology, physiopathology)
• Male
• Middle Aged
• Radioimmunoassay
• Renin (blood, physiology)
• Renin-Angiotensin System (physiology)
• White People