Blood aldosterone-to-renin ratio, ambulatory blood pressure, and left ventricular mass in children.
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.
Li
Rongling
R
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA. rli2@utmem.edu
Richey
Phyllis A
PA
DiSessa
Thomas G
TG
Alpert
Bruce S
BS
Jones
Deborah P
DP
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
D000450:Aldosterone; D012964:Sodium; D003404:Creatinine; D012083:Renin