Aldosterone-to-renin ratio and nocturnal blood pressure decline assessed by self-measurement of blood pressure at home: the Ohasama Study

作者：Satoh Michihiro; Hosaka Miki; Asayama Kei; Kikuya Masahiro; Inoue Ryusuke; Metoki Hirohito; Utsugi Megumi T; Hara Azusa; Hirose Takuo; Obara Taku; Mori Takefumi; Totsune Kazuhito; Hoshi Haruhisa; Mano Nariyasu; Imai Yutaka; Ohkubo Takayoshi^*

来源：Clinical and Experimental Hypertension, 2014, 36(2): 108-114.

DOI：10.3109/10641963.2014.892121

• Aldosterone
• home blood pressure
• non-dipping
• nocturnal decline in blood pressure renin

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 %26quot;non-dipping%26apos;%26apos; 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 %26gt;= 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 %26gt;= 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 (%26gt;= 128.4 mmHg) with a higher home night-time systolic BP (%26gt;= 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.

• 出版日期2014