The relationship between plasma renin activity and serum lipid profiles in patients with primary arterial hypertension

Abstract

Introduction:: The aim of the study was to evaluate clinical and biochemical differences between patients with low-renin and high-renin primary arterial hypertension (AH), mainly in reference to serum lipids, and to identify factors determining lipid concentrations.

Materials and methods:: In untreated patients with AH stage 1 we measured plasma renin activity (PRA) and subdivided the group into low-renin (PRA < 0.65 ng/mL/h) and high-renin (PRA ⩾ 0.65 ng/mL/h) AH. We compared office and 24-h ambulatory blood pressure, serum aldosterone, lipids and selected biochemical parameters between subgroups. Factors determining lipid concentration in both subgroups were assessed in regression analysis.

Results:: Patients with high-renin hypertension ( N = 58) were characterized by higher heart rate ( p = 0.04), lower serum sodium ( p < 0.01) and aldosterone-to-renin ratio ( p < 0.01), and significantly higher serum aldosterone ( p = 0.03), albumin ( p < 0.01), total protein ( p < 0.01), total cholesterol ( p = 0.01) and low-density lipoprotein cholesterol (LDL-C) ( p = 0.04) than low-renin subjects ( N = 39). In univariate linear regression, only PRA in the low-renin group was in a positive relationship with LDL-C ( R² = 0.15, β = 1.53 and p = 0.013); this association remained significant after adjustment for age, sex, and serum albumin and aldosterone concentrations.

Conclusions:: Higher serum levels of total and LDL-C characterized high-renin subjects, but the association between LDL-C level and PRA existed only in low-renin primary AH.

Keywords: Arterial hypertension; aldosterone; aldosterone-to-renin ratio; plasma renin activity; serum lipids.

Figure 1.

Association of low-density lipoprotein cholesterol with plasma renin activity in study subgroups: low-renin hypertension (low-density lipoprotein cholesterol = 2.51 +1.53 plasma renin activity; R²= 0.15; p = 0.013); high-renin hypertension (low-density lipoprotein cholesterol = 3.49 – 0.05 plasma renin activity; R² =0.006; p = 0.55). Circle: low-renin subject; square: high-renin subject. Dotted line shows plasma renin activity level of 0.65 ng/mL/h. LDL-C: low-density lipoprotein cholesterol; PRA: plasma renin activity.