Journal Article

Aldosterone-to-Renin Ratio and the Relationship Between Urinary Salt Excretion and Blood Pressure in a Community of African Ancestry

Leon Scott, Angela J. Woodiwiss, Muzi J. Maseko, Demetri G.A. Veliotes, Olebogeng H.I. Majane, Janice Paiker, Pinhas Sareli and Gavin R. Norton

in American Journal of Hypertension

Published on behalf of American Journal of Hypertension, Ltd.

Volume 24, issue 8, pages 951-957
Published in print August 2011 | ISSN: 0895-7061
Published online August 2011 | e-ISSN: 1941-7225 | DOI: http://dx.doi.org/10.1038/ajh.2011.49
Aldosterone-to-Renin Ratio and the Relationship Between Urinary Salt Excretion and Blood Pressure in a Community of African Ancestry

More Like This

Show all results sharing these subjects:

  • Neuroendocrinology and Autonomic Nervous System
  • Biochemistry
  • Endocrinology and Diabetes

GO

Show Summary Details

Preview

Background

Although aldosterone influences the effect of salt intake on blood pressure (BP), the extent to which this occurs at a population level is uncertain. We therefore aimed to determine, at a community level in a group of African descent, whether in the absence of primary aldosteronism, the relationship between salt intake and BP is modified by circulating aldosterone, and the extent to which this occurs.

Methods

In 575 participants of African ancestry (age >16 years), we assessed whether aldosterone-to-renin ratio (ARR) is associated with the relationship between urinary sodium (Na+)-to-potassium (K+) ratio (urinary Na+/K+) (from 24-h urine samples), an index of salt intake, and BP.

Results

With adjustments for confounders, interactions between ARR and urinary Na+/K+ were independently associated with systolic BP (SBP) (P < 0.0001), an effect that was accounted for by interactions between serum aldosterone concentrations and urinary Na+/K+ (P < 0.0001), but not between plasma renin concentrations and urinary Na+/K+ (P = 0.52). The interaction between ARR and urinary Na+/K+ translated into a marked difference in the relationship between urinary Na+/K+ and SBP in participants above compared to below the median for ARR (effect of 1s.d. increase in urinary Na+/K+ on SBP: ARR > median = 4.2 ± 0.6mmHg; ARR < median = 1.2 ± 0.4mmHg, P < 0.0001). In addition, participants with urinary Na+/K+ above the median had higher multivariate-adjusted SBP (P < 0.001) only if ARR was also above the median.

Conclusions

In groups of African descent, in the absence of primary aldosteronism, an increased aldosterone concentration relative to renin modifies a substantial proportion of the relationship between urinary Na+/K+ and BP at a community level.

American Journal of Hypertension, advance online publication 31 March 2011; doi:10.1038/ajh.2011.49

Keywords: African ancestry; aldosterone; ambulatory BP; blood pressure; hypertension; renin; salt intake

Journal Article.  5008 words.  Illustrated.

Subjects: Neuroendocrinology and Autonomic Nervous System ; Biochemistry ; Endocrinology and Diabetes

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.