Abstract-In high-Na ϩ , low-K ϩ diets, which suppress renin release in salt-sensitive groups, the mechanisms maintaining increases in renin-angiotensin-aldosterone system activation downstream from renin and renin-angiotensin-aldosterone system-induced effects on blood pressure (BP) are uncertain. Whether circulating angiotensinogen concentrations (AGT) or its determinants may contribute to maintaining serum aldosterone concentrations (aldosterone) and increases in BP on high-Na ϩ , low-K ϩ diets was evaluated in 579 participants of a community sample of African ancestry. Plasma renin concentrations were inversely related to BP (PϽ0.0001) and an index of salt intake (24-hour urinary Na ϩ /K ϩ , PϽ0.0001). An interaction between AGT and urinary Na ϩ /K ϩ was independently associated with aldosterone (PϽ0.001) and systolic BP (SBP; PϽ0.05). Independent of confounders, in participants with urinary Na ϩ /K ϩ at or more than the median for the sample, AGT was positively associated with aldosterone (PϽ0.0001) and SBP (PϽ0.005). No independent AGT-aldosterone or AGT-SBP relationships were noted in participants with urinary Na ϩ /K ϩ less than the median for the sample. Standardized -coefficients (slopes) of AGT-aldosterone and AGT-SBP relationships were greater in participants with urinary Na ϩ /K ϩ at or more than the median (AGT-aldosteroneϭ0.30Ϯ0.06, AGT-SBPϭ0.16Ϯ0.05) compared with those with urinary Na ϩ /K ϩ less than the median (AGT-aldosteroneϭϪ0.04Ϯ0.06; AGT-SBPϭϪ0.03Ϯ0.05; PϽ0.01-0.0001 for comparison of slopes). The AGT-SBP relationship in participants with urinary Na ϩ /K ϩ at or more than the median for the sample was equivalent to the relationship between body mass index and BP. In conclusion, in participants of African ancestry, in the presence of high-Na ϩ , low-K ϩ diets, which suppress renin release, renin-angiotensin-aldosterone system activation and its impact on BP are maintained in part by AGT. (Hypertension. 2012;59:62-69.) • Online Data Supplement Key Words: renin-angiotensin-aldosterone system Ⅲ salt intake Ⅲ angiotensinogen D espite the well-recognized role of the renin-angiotensinaldosterone system (RAAS) in blood pressure (BP) control, high-sodium (Na ϩ ), low-potassium (K ϩ ) diets in salt-sensitive populations suppress renin release. [1][2][3][4] Consequently, RAAS blockers may not produce beneficial effects on BP in salt-sensitive populations, such as those of African ancestry, 5,6 and despite the benefits that may accrue from RAAS blockers, 7-9 they are not recommended as first-line therapy in these groups. 10,11 Nonetheless, despite a low renin state, populations of African ancestry tend to have a disproportionately high prevalence of end-organ damage, 12,13 and in previous studies conducted in groups of African ancestry, a somewhat perplexing dissociation exists between a low renin status and relatively higher aldosterone concentrations. 14 Indeed, in low renin states in salt-sensitive individuals, reductions in plasma aldosterone concentrations may be less than those predicted from t...