title: The influence of serum aldosterone and the aldosterone-renin ratio on pulse wave velocity in hypertensive patients.
abstract: OBJECTIVE
  The aldosterone-renin ratio (ARR) is widely used to screen for primary aldosteronism, and may reflect a relative excess of aldosterone secretion compared with renin secretion. Excess aldosterone may have a detrimental effect on vascular stiffness. We therefore hypothesized that ARR and aldosterone are independently correlated with pulse wave velocity (PWV) in hypertensive patients.
  
  
  METHODS
  The study consisted of 438 hypertensive patients. Serum aldosterone and plasma renin activity were measured in a sitting position using standard techniques. The PWV was determined by measuring the heart to femoral PWV (hfPWV) and brachial to ankle PWV with a VP-2000 pulse wave unit.
  
  
  RESULTS
  Group 1 was defined as patients with ARR of at least 20 (n = 53) with serum aldosterone >or= 12 ng/dl, while the remainder comprised group 2. Comparisons between the two groups reveal group 1 tended to have higher age, significantly higher proportion of women and higher systolic/diastolic blood pressure. Patients in group 1 also had a significantly higher index of central arterial stiffness (hfPWV 1048 +/- 202 vs 978 +/- 182, P = 0.010) compared with group 2. Multiple linear regression revealed that aldosterone, but not the ARR, is significantly associated with hfPWV but not brachial to ankle PWV, after controlling for age, systolic blood pressure and heart rate at the time of PWV measurement, body mass index, gender, low-density lipoprotein-cholesterol, triglyceride, high-density lipoprotein-cholesterol, blood pressure medication and statins.
  
  
  CONCLUSIONS
  Serum aldosterone is significantly associated with central aortic PWV in hypertensive patients. The results demonstrate a possible role for aldosterone in developing central aortic stiffness and increased PWV in hypertensive patients.
authors.affiliation: Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.forename: Jin-Bae
authors.initials: JB
authors.lastname: Kim
authors.forename: Chi Young
authors.initials: CY
authors.lastname: Shim
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D011674:Pulse; D012044:Regression Analysis; D012083:Renin / Q000097:blood*
chemical_list: D000959:Antihypertensive Agents; D008055:Lipids; D000450:Aldosterone; D012083:Renin