title: Significance of urinary angiotensinogen in essential hypertension as a function of plasma renin and aldosterone status.
abstract: 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.
authors.affiliation: 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
authors.forename: Pierre
authors.initials: P
authors.lastname: Lantelme
authors.forename: Andreas
authors.initials: A
authors.lastname: Rohrwasser
authors.forename: Madeleine
authors.initials: M
authors.lastname: Vincent
authors.forename: Tong
authors.initials: T
authors.lastname: Cheng
authors.forename: Stéphany
authors.initials: S
authors.lastname: Gardier
authors.forename: Liliana
authors.initials: L
authors.lastname: Legedz
authors.forename: Giampiero
authors.initials: G
authors.lastname: Bricca
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Lalouel
authors.forename: Hugues
authors.initials: H
authors.lastname: Milon
mesh_terms: 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
chemical_list: D000808:Angiotensinogen; D000450:Aldosterone; D012083:Renin