title: Aldosterone-to-renin ratio and nocturnal blood pressure decline assessed by self-measurement of blood pressure at home: the Ohasama Study.
abstract: Based on ambulatory blood pressure (BP) monitoring, the aldosterone-to-renin ratio (ARR) has been reported to be associated with a diminished nocturnal decline in BP, generally referred to as a "non-dipping" pattern. The objective of this cross-sectional study was to investigate the association between ARR and the non-dipping pattern based on home BP measurements. This study included 177 participants≥55 years from the general population of Ohasama (mean age: 67.2 years; 74.6% women); no patient was receiving antihypertensive treatment. The median plasma renin activity (PRA), plasma aldosterone concentration (PAC) and ARR were 0.8 ng/mL/h, 8.1 ng/dL and 9.7 ng/dL per ng/mL/h, respectively. Each 1 SD increase in log-transformed (ln) ARR was significantly associated with the prevalence of the non-dipping pattern after adjustments for possible confounding factors including home morning systolic BP (odds ratio, 1.45; p=0.049). However, no significant associations of PRA or PAC with the non-dipping pattern were observed (p≥0.2). When participants were divided into four groups according to median levels of home morning and night-time systolic BPs, the group with a higher home morning systolic BP (≥128.4 mmHg) with a higher home night-time systolic BP (≥114.4 mmHg) had the greatest ARR levels (ANCOVA p=0.01). These results support the hypothesis that relative aldosterone excess may be related to a non-dipping pattern in a general population and suggest that a non-dipping pattern can be accurately observed by home BP measurements.
authors.affiliation: Department of Pharmacy, Tohoku University Hospital , Sendai , Japan .
authors.forename: Michihiro
authors.initials: M
authors.lastname: Satoh
authors.forename: Miki
authors.initials: M
authors.lastname: Hosaka
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Hirohito
authors.initials: H
authors.lastname: Metoki
authors.forename: Megumi T
authors.initials: MT
authors.lastname: Utsugi
authors.forename: Azusa
authors.initials: A
authors.lastname: Hara
authors.forename: Takuo
authors.initials: T
authors.lastname: Hirose
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Takefumi
authors.initials: T
authors.lastname: Mori
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Totsune
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Hoshi
authors.forename: Nariyasu
authors.initials: N
authors.lastname: Mano
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy; D007564:Japan; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood*
chemical_list: D000959:Antihypertensive Agents; D000450:Aldosterone; D012083:Renin