TY - JOUR
T1 - Plasma renin and outcome in the community
T2 - Data from PREVEND
AU - De Boer, Rudolf A.
AU - Schroten, Nicolas F.
AU - Bakker, Stephan J.L.
AU - Mahmud, Hasan
AU - Szymanski, Mariusz K.
AU - Van Der Harst, Pim
AU - Gansevoort, Ron T.
AU - Van Veldhuisen, Dirk J.
AU - Van Gilst, Wiek H.
AU - Hillege, Hans L.
PY - 2012/9
Y1 - 2012/9
N2 - Aims: The reninangiotensin system plays a central role in patients with established cardiovascular (CV) disease, but the prognostic effect of plasma renin in the community is unclear. Methods and results:The relationship between plasma renin concentration and CV events was studied in 6228 subjects who were enrolled in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study, and who were not using antihypertensive medication. Plasma renin concentration was measured using a direct automated immunochemiluminescent assay. The mean (±SD) age was 47(±12) years, 49 were male; the mean follow-up was 10.5 years. The median (Q1Q3) plasma renin was 17.6 (10.927.2) IU/mL, and plasma aldosterone was 119 (93153) ng/L. The primary outcome was a composite of fatal (n=27) and non-fatal (n=408) CV events. Adjusted for age and sex each doubling of plasma renin was associated with a hazard ratio (HR) for the primary outcome of 1.22 (95 CI: 1.041.43; P=0.015). In a multivariable model, plasma renin showed a positive correlation with heart rate and male sex and a negative correlation with blood pressure, urinary sodium, glucose, and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) (adjusted R2: 0.167, P< 0.001). After adjustment for covariates associated with plasma renin, the HR for reaching the primary outcome was 1.28 (95 CI: 1.091.49, P=0.002). Plasma renin was associated with CV events regardless of blood pressure, but in subjects using antihypertensive medication this association was absent. Conclusion:Plasma renin concentration is associated with an increased risk for CV events in a community-based cohort not on antihypertensive medication.
AB - Aims: The reninangiotensin system plays a central role in patients with established cardiovascular (CV) disease, but the prognostic effect of plasma renin in the community is unclear. Methods and results:The relationship between plasma renin concentration and CV events was studied in 6228 subjects who were enrolled in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study, and who were not using antihypertensive medication. Plasma renin concentration was measured using a direct automated immunochemiluminescent assay. The mean (±SD) age was 47(±12) years, 49 were male; the mean follow-up was 10.5 years. The median (Q1Q3) plasma renin was 17.6 (10.927.2) IU/mL, and plasma aldosterone was 119 (93153) ng/L. The primary outcome was a composite of fatal (n=27) and non-fatal (n=408) CV events. Adjusted for age and sex each doubling of plasma renin was associated with a hazard ratio (HR) for the primary outcome of 1.22 (95 CI: 1.041.43; P=0.015). In a multivariable model, plasma renin showed a positive correlation with heart rate and male sex and a negative correlation with blood pressure, urinary sodium, glucose, and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) (adjusted R2: 0.167, P< 0.001). After adjustment for covariates associated with plasma renin, the HR for reaching the primary outcome was 1.28 (95 CI: 1.091.49, P=0.002). Plasma renin was associated with CV events regardless of blood pressure, but in subjects using antihypertensive medication this association was absent. Conclusion:Plasma renin concentration is associated with an increased risk for CV events in a community-based cohort not on antihypertensive medication.
UR - https://www.scopus.com/pages/publications/84866414122
U2 - 10.1093/eurheartj/ehs198
DO - 10.1093/eurheartj/ehs198
M3 - Article
C2 - 22807466
AN - SCOPUS:84866414122
SN - 0195-668X
VL - 33
SP - 2351
EP - 2359
JO - European Heart Journal
JF - European Heart Journal
IS - 18
ER -