title: Blood aldosterone-to-renin ratio, ambulatory blood pressure, and left ventricular mass in children.
abstract: OBJECTIVE
  To assess the blood aldosterone-to-renin ratio (ARR) and its relationship to ambulatory blood pressure (ABP) and left ventricular mass (LVM) in children.
  
  
  METHODS
  A cross-sectional clinical study was conducted in 102 children (71.6% African American; 62.7% male) ranging in age from 7 to 18 years (mean, 13.6 years; median, 14 years). ABP (24-hour monitoring) was expressed as blood pressure index (BPI; mean blood pressure/95th percentile by sex and height). LVM was measured by echocardiography and expressed as an index (LVMI = g/height [m](2.7)). Regression analyses were used to estimate associations.
  
  
  RESULTS
  African-American children had significantly lower serum aldosterone concentration and plasma renin activity compared with European-American children (aldosterone: 5.9 ng/dL vs 11.4 ng/dL, P < .0001; renin: 1.6 ng/mL/hour vs 2.8 ng/mL/hour, P = .01). However, ARR was not significantly different by race. ARR was not associated with 24-hour ABP but was significantly associated with LVMI (beta = 0.4 g/m(2.7); P = .02) after adjustment for the ratio of 24-hour urine Na to creatinine excretion, body mass index z- score, and ABP index.
  
  
  CONCLUSIONS
  The data indicated a significant association between ARR and LVMI, but not ABP, in children, suggesting early cardiac remodeling associated with a high ARR.
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA. rli2@utmem.edu
authors.forename: Rongling
authors.initials: R
authors.lastname: Li
authors.forename: Phyllis A
authors.initials: PA
authors.lastname: Richey
authors.forename: Thomas G
authors.initials: TG
authors.lastname: DiSessa
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Alpert
authors.forename: Deborah P
authors.initials: DP
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000450:Aldosterone / Q000097:blood*; D044383:Black People; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002648:Child; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012083:Renin / Q000097:blood*; D012737:Sex Factors; D012964:Sodium / Q000652:urine; D014463:Ultrasonography; D044465:White People; D001741:Black or African American
chemical_list: D000450:Aldosterone; D012964:Sodium; D003404:Creatinine; D012083:Renin