Plasma renin activity and risk of cardiovascular and mortality outcomes among individuals with elevated and nonelevated blood pressure.
10.1016/j.krcp.2016.07.004
- Author:
Simran K BHANDARI
1
;
Michael BATECH
;
Jiaxiao SHI
;
Steven J JACOBSEN
;
John J SIM
Author Information
1. Division of Nephrology and Hypertension, Department of Internal Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA. simran.x.bhandari@kp.org
- Publication Type:Original Article
- Keywords:
Cardiovascular outcomes;
Epidemiology;
Mortality;
Plasma renin activity
- MeSH:
Adult;
Blood Pressure*;
Cohort Studies;
Epidemiology;
Heart;
Heart Failure;
Humans;
Mortality*;
Plasma*;
Proportional Hazards Models;
Renin*;
Retrospective Studies;
Stroke
- From:Kidney Research and Clinical Practice
2016;35(4):219-228
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We sought to evaluate plasma renin activity (PRA) levels and risk of mortality and cardiovascular events among individuals with elevated blood pressure [systolic blood pressure (SBP) ≥ 140 mmHg] and those with controlled blood pressure (SBP < 140 mmHg) in a large diverse population. METHODS: A retrospective cohort study between January 1, 2007, and December 31, 2013, among adults (≥ 18 years) within an integrated health system was conducted. Subjects were categorized by SBP into 2 groups: SBP < 140 mmHg and SBP ≥ 140 mmHg and then further categorized into population-based PRA tertiles within each SBP group. Cox proportional hazard modeling was used to estimate hazard ratios for cardiovascular and mortality outcomes among tertiles of PRA levels. RESULTS: Among 6,331 subjects, 32.6% had SBP ≥ 140 mmHg. Multivariable hazard ratios and 95% confidence interval for PRA tertiles T2 and T3 compared to T1 in subjects with SBP ≥ 140 mmHg were 1.42 (0.99–2.03) and 1.61 (1.12–2.33) for ischemic heart events; 1.40 (0.93–2.10) and 2.23 (1.53–3.27) for congestive heart failure; 1.10 (0.73–1.68) and 1.06 (0.68–1.66) for cerebrovascular accident; 1.23 (0.94–1.59) and 1.43 (1.10–1.86) for combined cardiovascular events; and 1.39 (0.97–1.99) and 1.35 (0.92–1.97) for all-cause mortality, respectively. Among the SBP < 140 mmHg group, there was no relationship between PRA levels and outcomes. CONCLUSION: Higher PRA levels demonstrated increased risk for ischemic heart events and congestive heart failure and a trend toward higher mortality among individuals with SBP ≥ 140 mmHg but not among those with SBP < 140 mmHg.
