title: Association of renin and aldosterone with ethnicity and blood pressure: the Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  Although variations in plasma renin activity (PRA) and aldosterone have been examined in whites and blacks, the association of these hormones with blood pressure in multiethnic populations has not been described.
  
  
  METHODS
  We measured PRA and aldosterone in 1,021 participants in the Multi-Ethnic Study of Atherosclerosis not taking antihypertensives and examined the association between ethnicity and PRA/aldosterone and the association between PRA/aldosterone with systolic blood pressure (SBP).
  
  
  RESULTS
  Average age was 62 (SD = 9) years, and 49% of participants were women. Median PRA was 0.51 (interquartile range (IQR) = 0.29-0.87) ng/ml/hour, and median aldosterone was 12.6 (IQR = 9.1-17.1) ng/dl. After age and sex adjustment, compared with whites, blacks had 28% lower PRA and 17.4% lower aldosterone, and Hispanics had 20.1% higher PRA but similar aldosterone levels. After multivariable adjustment, compared with whites, only Hispanic ethnicity independently associated with higher PRA (0.18ng/ml/hour; 95% confidence interval (CI) = 0.06-0.31). Blacks had lower aldosterone (-1.7ng/dl; 95% CI = -3.2 to -0.2) compared with whites. After multivariable adjustment, PRA was associated with lower SBP in whites (-3.2mm Hg; 95% CI = -5.2 to -1.2 per standardized unit PRA), Chinese (-3.5mm Hg; 95% CI = -6.2 to -0.80 per standardized unit), and Hispanics (-2.3mm Hg; 95% CI = -4.1 to -0.6 per standardized unit) but not blacks. Aldosterone was associated with higher SBP only in Hispanics (2.5mm Hg; 95% CI = 0.4-4.5 per SD).
  
  
  CONCLUSIONS
  Compared with whites, blacks have lower aldosterone and Hispanics have higher PRA. Aldosterone had significant associations with higher SBP in Hispanics compared with other groups, a finding that may suggest a different mechanism of hypertension.
authors.affiliation: Division of Nephrology, Department of Medicine, University of California-San Diego, San Diego, California.
authors.forename: Dena E
authors.initials: DE
authors.lastname: Rifkin
authors.forename: Ali R
authors.initials: AR
authors.lastname: Khaki
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Jenny
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McClelland
authors.forename: Matthew
authors.initials: M
authors.lastname: Budoff
authors.forename: Karol
authors.initials: K
authors.lastname: Watson
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Allison
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood*; D044466:Asian People; D050197:Atherosclerosis / Q000175:diagnosis / Q000208:ethnology*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D016009:Chi-Square Distribution; D005006:Ethnicity; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012083:Renin / Q000097:blood*; D012084:Renin-Angiotensin System; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D044465:White People
chemical_list: D015415:Biomarkers; D000450:Aldosterone; D012083:Renin
keywords: Chinese; Hispanic; black; blood pressure; cross-sectional analysis; hypertension; white.