Blood Aldosterone-to-Renin Ratio, Ambulatory Blood Pressure, and Left Ventricular Mass in Children
Received 27 August 2008; received in revised form 14 January 2009; accepted 12 February 2009. published online 22 May 2009.
Refers to article:
Pre-hypertension and Hypertension in Pediatrics: Don't Let the Statistics Hide the Pathology
R. Thomas Collins, Bruce S. Alpert
The Journal of Pediatrics
August 2009 (Vol. 155, Issue 2, Pages 165-169) Full Text |
Full-Text PDF (109 KB)
Should the Current Approach to the Evaluation and Treatment of High Blood Pressure in Children Be Changed?
Joseph T. Flynn, Bonita E. Falkner
The Journal of Pediatrics
August 2009 (Vol. 155, Issue 2, Pages 157-158) Full Text |
Full-Text PDF (79 KB)
Childhood Prevention of Hypertensive Cardiovascular Disease
Matthew W. Gillman
The Journal of Pediatrics
August 2009 (Vol. 155, Issue 2, Pages 159-161) Full Text |
Full-Text PDF (80 KB)
Objective
To assess the blood aldosterone-to-renin ratio (ARR) and its relationship to ambulatory blood pressure (ABP) and left ventricular mass (LVM) in children.
Study design
A cross-sectional clinical study was conducted in 102 children (71.6% African American; 62.7% male) ranging in age from 7 to 18 years (mean, 13.6 years; median, 14 years). ABP (24-hour monitoring) was expressed as blood pressure index (BPI; mean blood pressure/95th percentile by sex and height). LVM was measured by echocardiography and expressed as an index (LVMI = g/height [m]2.7). Regression analyses were used to estimate associations.
Results
African-American children had significantly lower serum aldosterone concentration and plasma renin activity compared with European-American children (aldosterone: 5.9 ng/dL vs 11.4 ng/dL, P < .0001; renin: 1.6 ng/mL/hour vs 2.8 ng/mL/hour, P = .01). However, ARR was not significantly different by race. ARR was not associated with 24-hour ABP but was significantly associated with LVMI (β = 0.4 g/m2.7; P = .02) after adjustment for the ratio of 24-hour urine Na to creatinine excretion, body mass index z- score, and ABP index.
Conclusions
The data indicated a significant association between ARR and LVMI, but not ABP, in children, suggesting early cardiac remodeling associated with a high ARR.
aDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
bDepartment of Pediatrics, University of Tennessee Health Science Center, Memphis, TN
cDepartment of Pediatrics, University of Kentucky Medical School, Lexington, KY
dGeneral Clinical Research Center, Children's Foundation Research Center at Le Bonheur Children's Medical Center, Memphis, TN
Reprint requests: Rongling Li, MD, PhD, Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N Pauline Street, Suite 633, Memphis, TN 38163.
Supported by grants from the Children's Foundation Research Center at Le Bonheur Children's Medical Center and the University of Tennessee Health Science Center, the US Public Health Service (MO1 RR-00211), and the National Institutes of Health (NHLBI 5K23HL83910-2). The authors declare no conflicts of interest.
ABSTRACT