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Huang CC, Leu HB, Huang PH, et al. Baseline Serum Aldosterone-to-Renin Ratio is Associated with the Add-on Effect of Thiazide Diuretics in Non-Diabetic Essential Hypertensives. Acta Cardiol Sin. 2013;29(1):37-48
Huang, C. C., Leu, H. B., Huang, P. H., Wu, T. C., Lin, S. J., & Chen, J. W. (2013). Baseline Serum Aldosterone-to-Renin Ratio is Associated with the Add-on Effect of Thiazide Diuretics in Non-Diabetic Essential Hypertensives. Acta Cardiologica Sinica, 29(1), 37-48.
Huang, Chin-Chou, et al. "Baseline Serum Aldosterone-to-Renin Ratio is Associated with the Add-on Effect of Thiazide Diuretics in Non-Diabetic Essential Hypertensives." Acta Cardiologica Sinica vol. 29,1 (2013): 37-48.
Huang CC, Leu HB, Huang PH, Wu TC, Lin SJ, Chen JW. Baseline Serum Aldosterone-to-Renin Ratio is Associated with the Add-on Effect of Thiazide Diuretics in Non-Diabetic Essential Hypertensives. Acta Cardiol Sin. 2013 Jan;29(1):37-48. PMID: 27122683; PMCID: PMC4804959.
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Acta Cardiol Sin. 2013 Jan;29(1):37-48.

Baseline Serum Aldosterone-to-Renin Ratio is Associated with the Add-on Effect of Thiazide Diuretics in Non-Diabetic Essential Hypertensives.

Acta Cardiologica Sinica

Chin-Chou Huang, Hsin-Bang Leu, Po-Hsun Huang, Tao-Cheng Wu, Shing-Jong Lin, Jaw-Wen Chen

Affiliations

  1. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan; ; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; ; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; ; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan;
  2. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; ; Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan; ; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; ; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
  3. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; ; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; ; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
  4. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan; ; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; ; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; ; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.

PMID: 27122683 PMCID: PMC4804959

Abstract

BACKGROUND: The baseline status of renin-angiotensin-aldosterone system (RAAS) might modify the blood pressure (BP) lowering effects of thiazide diuretics. This study aimed to determine if baseline RAAS indicated by serum aldosterone-to-renin ratio (ARR) could be associated with the add-on effects of thiazide on BP lowering in patients with other concomitant antihypertensive medication.

METHODS: Non-diabetic hypertensive patients, either untreated or unsatisfactorily treated, were enrolled if their office systolic BP was ≥ 140 or diastolic BP ≥ 90 mmHg. After 2 weeks of diet control and lifestyle modification, patients with persistently elevated BP were prospectively given hydrochlorothiazide 50 mg daily for 2 weeks. Serum aldosterone-to-renin ratio (ARR) was determined before thiazide treatment. Patients with a significant (≥ 10%) reduction of office mean artery pressure (MAP) by thiazide treatment were defined as responders.

RESULTS: Among the 66 patients studied, 27 were defined as responders after a 2-week hydrochlorothiazide treatment. Baseline serum renin level was reduced and ARR increased (p = 0.009) in the responders as compared with the non-responders. A similar pattern was also apparent in patients with or without concomitant medications. Furthermore, baseline renin level was inversely and ARR positively correlated to the MAP reduction both in the whole patient group and in patients with concomitant medications. By stepwise multiple linear regression analysis, ARR was the only independent predictor for the response to thiazide treatment (β = 0.051, p = 0.007).

CONCLUSIONS: Baseline ARR could be associated with the add-on effects of hydrochlorothiazide on BP reduction in patients with other concomitant antihypertensive treatment.

KEY WORDS: Add-on; Aldosterone-to-renin ratio; Blood pressure; Hydrochlorothiazide; Hypertension; Renin; Thiazide.

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