title: Plasma aldosterone levels and aldosterone-to-renin ratios are associated with endothelial dysfunction in young to middle-aged subjects.
abstract: OBJECTIVE
  Small clinical studies suggested a role for aldosterone in the development of endothelial dysfunction. We investigated whether the plasma aldosterone concentration (PAC) or the aldosterone-to-renin ratio (ARR) were associated with decreased endothelial function as measured by flow-mediated dilation (FMD) of the brachial artery in the general population.
  
  
  METHODS
  Our study population comprised 972 participants from the Study of Health in Pomerania, who were not treated with antihypertensive medication. We performed age-stratified (<50 and ≥ 50 years) ordinal logistic regression analyses. FMD was categorised as decreased (1st quintile), moderate (2nd-4th quintile), or increased (5th quintile). PAC and ARR were divided into low, moderate, and high values according to age- and sex-specific tertiles. All models were re-calculated for 871 subjects with PAC and ARR within the study-specific reference ranges. Odds ratios (OR) and 95% confidence intervals (CI) are presented.
  
  
  RESULTS
  Subjects <50 years with high PAC (OR 1.60; 95% CI 1.07-2.38) or ARR (OR 1.81; 95% CI 1.21-2.73) had higher odds for decreased FMD than subjects with low PAC or ARR, respectively. Similar results were obtained in analyses restricted to subjects with PAC and ARR within the reference range. High-normal PAC (OR 1.62; 95% CI 1.07-2.47) or ARR (OR 1.62; 95% CI 1.05-2.50) was associated with higher odds for decreased FMD when compared with low-normal PAC or ARR, respectively. These associations were not observed in subjects ≥ 50 years.
  
  
  CONCLUSIONS
  High and high-normal PAC or ARR contribute to an impaired FMD and subsequently the progression of subclinical atherosclerosis in young to middle-aged subjects.
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany. anke.hannemann@uni-greifswald.de
authors.forename: A
authors.initials: A
authors.lastname: Hannemann
authors.forename: H
authors.initials: H
authors.lastname: Wallaschofski
authors.forename: J
authors.initials: J
authors.lastname: Lüdemann
authors.forename: H
authors.initials: H
authors.lastname: Völzke
authors.forename: M R
authors.initials: MR
authors.lastname: Markus
authors.forename: R
authors.initials: R
authors.lastname: Rettig
authors.forename: U
authors.initials: U
authors.lastname: Lendeckel
authors.forename: M
authors.initials: M
authors.lastname: Reincke
authors.forename: S B
authors.initials: SB
authors.lastname: Felix
authors.forename: K
authors.initials: K
authors.lastname: Empen
authors.forename: M
authors.initials: M
authors.lastname: Nauck
authors.forename: M
authors.initials: M
authors.lastname: Dörr
mesh_terms: D000328:Adult; D000367:Age Factors; D000375:Aging; D000450:Aldosterone / Q000097:blood*; D050197:Atherosclerosis / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000378:metabolism / Q000503:physiopathology*; D016009:Chi-Square Distribution; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012083:Renin / Q000097:blood*; D012084:Renin-Angiotensin System; D018570:Risk Assessment; D012307:Risk Factors; D015854:Up-Regulation; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D000450:Aldosterone; D012083:Renin