Significance of urinary angiotensinogen in essential hypertension as a function of plasma renin and aldosterone status.
OBJECTIVE
This study was performed to test the significance of urinary angiotensinogen (UAGT) in essential hypertensive patients stratified as a function of plasma renin and aldosterone.


RESULTS
A sample of 248 essential hypertensives, investigated under their usual sodium diet and either off-medication or under a standardized treatment, was separated into two groups on the basis of upright plasma active renin and aldosterone medians. Patients with plasma active renin and aldosterone below medians are referred to as the low renin-aldosterone essential hypertensive group (LRA-EH). Others subjects are defined as other essential hypertensives (O-EH). Blood pressure (BP) was recorded by 24-h ambulatory monitoring. UAGT was measured by a specific enzyme-linked immunosorbent assay for total angiotensinogen. Because UAGT was markedly increased in the presence of overt proteinuria (>/= 300 mg/24 h), proteinuric patients (n = 29) were excluded from subsequent analyses. UAGT was a significant predictor of systolic and diastolic BP in LRA-EH females (P < 0.01 and P = 0.05, respectively) but not in males. By contrast, urinary sodium excretion (P < 0.001) and maintenance of treatment (P = 0.002) were significant predictors of systolic BP in males. These correlations were not observed in O-EH, whether males or females.


CONCLUSIONS
In the present study, UAGT stands as a strong predictor of BP in women with low plasma renin/aldosterone, suggesting an involvement of the tubular renin-angiotensin system in these subjects. Higher sodium intake or the need to maintain treatment may account in part for the lack of a similar relationship in males.
Lantelme
Pierre
P
UMR-MA 103, Université Claude Bernard Lyon 1, Lyon bService de Cardiologie, Hôpital de la Croix-Rousse (Hospices Civils de Lyon), Faculté de Médecine Lyon-Nord, Lyon, France. pierrelantelme@hotmail.com
Rohrwasser
Andreas
A
Vincent
Madeleine
M
Cheng
Tong
T
Gardier
Stéphany
S
Legedz
Liliana
L
Bricca
Giampiero
G
Lalouel
Jean-Marc
JM
Milon
Hugues
H
D000368:Aged; D000450:Aldosterone / Q000097:blood*; D000808:Angiotensinogen / Q000652:urine*; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000652:urine; D012083:Renin / Q000097:blood*; D012084:Renin-Angiotensin System / Q000502:physiology*; D012737:Sex Factors
D000808:Angiotensinogen; D000450:Aldosterone; D012083:Renin