Aldosterone-to-renin ratio is related to arterial stiffness when the screening criteria of primary aldosteronism are not met

Kokko, Eeva; Nevalainen, Pasi; Choudhary, Manoj Kumar; Koskela, Jenni; Tikkakoski, Antti; Huhtala, Heini; Niemelä, Onni; Viukari, Marianna; Mustonen, Jukka; Matikainen, Niina; Pörsti, Ilkka

doi:10.1038/s41598-020-76718-7

Cited by 5 publications

(4 citation statements)

References 63 publications

(66 reference statements)

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“…The lack of correlation between haemoglobin and AIx or AIx@75 can probably be explained by the fact that these measures of wave reflection are also influenced by aortic dimensions, heart rate, stroke volume, and systemic vascular resistance in addition to large artery stiffness [32,44,45]. In the regression analyses, age, prevailing BP, heart rate, uric acid, and aldosterone to renin ratio showed the strongest associations with PWV, corresponding to previous studies [25,46]. The impact of haemoglobin concentration was of a lower magnitude (Beta value = 0.07) in regression analyses, but it was still an independent explanatory factor for PWV.…”

Section: Discussionsupporting

confidence: 74%

Blood Haemoglobin Concentration Is Directly and Independently Related with Pulse Wave Velocity, a Measure of Large Artery Stiffness

Choudhary,

Bouquin,

Hytönen

et al. 2023

JCM

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High haemoglobin level has been associated with metabolic syndrome, elevated blood pressure (BP), and increased mortality risk. In this cross-sectional study, we investigated the association of blood haemoglobin with haemodynamics in 743 subjects, using whole-body impedance cardiography and pulse wave analysis. The participants were allocated to sex-stratified haemoglobin tertiles with mean values 135, 144, and 154 g/L, respectively. The mean age was similar in all tertiles, while body mass index was higher in the highest versus the lowest haemoglobin tertile. The highest haemoglobin tertile had the highest erythrocyte and leukocyte counts, plasma C-reactive protein, uric acid, renin activity, and aldosterone. The lipid profile was less favourable and insulin sensitivity lower in the highest versus the lowest haemoglobin tertile. Aortic BP, cardiac output, and systemic vascular resistance were similar in all tertiles, while the pulse wave velocity (PWV) was higher in the highest versus the lowest haemoglobin tertile. In linear regression analysis, age (Beta 0.478), mean aortic BP (Beta 0.178), uric acid (Beta 0.150), heart rate (Beta 0.148), and aldosterone-to-renin ratio (Beta 0.123) had the strongest associations with PWV (p < 0.001 for all). Additionally, haemoglobin concentration was an explanatory factory for PWV (Beta 0.070, p = 0.028). To conclude, blood haemoglobin concentration had a small direct and independent association with a measure of large artery stiffness.

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Section: Discussionsupporting

confidence: 74%

Blood Haemoglobin Concentration Is Directly and Independently Related with Pulse Wave Velocity, a Measure of Large Artery Stiffness

Choudhary,

Bouquin,

Hytönen

et al. 2023

JCM

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“…Recently, Kokko and colleagues found ARR was associated with arterial stiffness in a cross-sectional study of normotensive and untreated HT patients (n = 545) who did not meet (strict) PA screening criteria: Ald > 20 ug/dl combined with ARR > 27, kaliemia < 3.3 mmol/l and/or BP > 150/100 mmHg [62]. Regression analysis showed an ageindependent association between ARR and pulse wave velocity.…”

Section: Main Findingsmentioning

confidence: 99%

Autonomous Aldosterone Secretion as a Subclinical Form of Primary Aldosteronism: Pathogenesis and Clinical Significance

Kmieć

Sworczak

2021

Exp Clin Endocrinol Diabetes

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In recent years, a substantial prevalence of primary aldosteronism (PA) has been demonstrated in both normotensive and mildly hypertensive cohorts. Consequently, a classic presentation of the syndrome, i. e. moderate-to-severe and resistant hypertension with concomitant hypokalemia, should be considered a tip-of-the-iceberg phenotype of a wide PA spectrum. Its entire range encompasses the non-classic clinical forms of mild hypertension and prehypertension but also several biochemical presentations, including patients who meet PA screening and confirmation test criteria, as well as those with either of them and those with other parameters indicating mineralocorticoid excess. In the current review, research insights on the pathogenetic background and clinical significance of autonomous aldosterone secretion (AAS) are presented, which is defined as a constellation of either: 1) normotension, normokalemia, a positive PA screening (high aldosterone-to-renin ratio) and/or confirmation test, or 2) hypertension, normokalemia and a positive PA screening but negative confirmation test. For this purpose, a literature search of the PubMed database was conducted. Advances in immunohistochemistry and genetic sequencing of isolated adrenal cells are provided as probable morphologic basis of the wide range of aldosterone secretion autonomy. Also, the role of corticotropin as an aldosterone secretagogue is discussed. To date, clinical studies depict consequences of subclinical PA phenotypes, such as increased mortality and risk of developing hypertension, impaired arterial and kidney function, association with metabolic syndrome and age, as well as osteoporosis.

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“…Semakin tinggi nilai ARR, risiko progresivitas penyakit kardiovaskular pada masa yang akan datang semakin meningkat. 18 Belarbia, dkk. (2015) memperlihatkan bahwa ARR berkorelasi positif dengan umur dan berkorelasi negatif dengan GFR.…”

Section: Medical Reviewunclassified

Pemeriksaan Aldosterone/Renin Ratio Sebagai Prediktor Penyakit Ginjal Kronis Pada Penderita Hipertensi

Dewi¹

2022

MEDICINUS

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Prevalensi penyakit ginjal kronis (PGK) semakin meningkat. Hipertensi merupakan faktor risiko utama terjadinya penyakit ginjal kronis, dengan angka prevalensi yang tinggi di Indonesia. Hingga saat ini belum terdapat pemeriksaan yang dapat digunakan sebagai prediktor terjadinya penurunan fungsi ginjal, terutama pada penderita hipertensi. Akhir-akhir ini banyak dilakukan studi untuk melihat hubungan antara kadar aldosterone dalam plasma (plasma aldosterone concentration/PAC) dengan penyakit ginjal kronis. Studi menunjukkan bahwa aldosterone/renin ratio (ARR) dapat menjadi parameter yang menjanjikan untuk memprediksi kejadian PGK. Hasil penelitian ini memberikan harapan pada pasien hipertensi, karena saat ini kejadian PGK lebih dapat terprediksi, berikut juga kejadian kardio- dan/atau serebrovaskular. Secara khusus bagi kelompok etnik Asia Timur yang dikenal dengan konsumsi garamnya yang tinggi, ARR juga dapat berperan sebagai penanda sensitivitas terhadap asupan garam, yang diharapkan dapat membantu dalam pengaturan restriksi garam dalam pola makan sehari-hari.

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Aldosterone-to-renin ratio is related to arterial stiffness when the screening criteria of primary aldosteronism are not met

Cited by 5 publications

References 63 publications

Blood Haemoglobin Concentration Is Directly and Independently Related with Pulse Wave Velocity, a Measure of Large Artery Stiffness

Blood Haemoglobin Concentration Is Directly and Independently Related with Pulse Wave Velocity, a Measure of Large Artery Stiffness

Autonomous Aldosterone Secretion as a Subclinical Form of Primary Aldosteronism: Pathogenesis and Clinical Significance

Pemeriksaan Aldosterone/Renin Ratio Sebagai Prediktor Penyakit Ginjal Kronis Pada Penderita Hipertensi

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