Plasma Renin Activity Is a Predictive Biomarker of Blood Pressure Response in European but not in African Americans With Uncomplicated Hypertension

Plasma renin activity (PRA) is a predictive biomarker of blood pressure (BP) response to antihypertensives in European–American hypertensive patients. We aimed to identify the metabolic signatures of baseline PRA and the linkages with BP response to β-blockers and thiazides. Using data from the Pharmacogenomic Evaluation of Antihypertensive Responses-2 (PEAR-2) trial, multivariable linear regression adjusting for age, sex and baseline systolic-BP (SBP) was performed on European–American individuals treated with metoprolol (n = 198) and chlorthalidone (n = 181), to test associations between 856 metabolites and baseline PRA. Metabolites with a false discovery rate (FDR) < 0.05 or p < 0.01 were tested for replication in 463 European–American individuals treated with atenolol or hydrochlorothiazide. Replicated metabolites were then tested for validation based on the directionality of association with BP response. Sixty-three metabolites were associated with baseline PRA, of which nine, including six lipids, were replicated. Of those replicated, two metabolites associated with higher baseline PRA were validated: caprate was associated with greater metoprolol SBP response (β = −1.7 ± 0.6, p = 0.006) and sphingosine-1-phosphate was associated with reduced hydrochlorothiazide SBP response (β = 7.6 ± 2.8, p = 0.007). These metabolites are clustered with metabolites involved in sphingolipid, phospholipid, and purine metabolic pathways. The identified metabolic signatures provide insights into the mechanisms underlying BP response.

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Pretreatment levels of plasma renin activity predict ambulatory blood pressure response to valsartan in essential hypertension

Journal of Human Hypertension ◽

10.1038/jhh.2009.31 ◽

2009 ◽

Vol 23 (10) ◽

pp. 683-686 ◽

Cited By ~ 2

Author(s):

J Minami ◽

E Ohno ◽

S Furukata ◽

T Ishimitsu ◽

H Matsuoka

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Plasma Renin Activity ◽

Ambulatory Blood Pressure ◽

Blood Pressure Response ◽

Plasma Renin ◽

Pressure Response ◽

Renin Activity

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Effect of Cyclo-Oxygenase Inhibition on Renin, Catecholamine and Blood Pressure Responses to Haemorrhage and Captopril in Conscious Rabbits

Clinical Science ◽

10.1042/cs063243s ◽

1982 ◽

Vol 63 (s8) ◽

pp. 243s-246s

Author(s):

M. S. Golub ◽

M. E. Berger ◽

N. D. Vlachakis ◽

P. Eggena ◽

M. P. Sambhi

Keyword(s):

Blood Pressure ◽

Drinking Water ◽

Plasma Renin Activity ◽

Blood Pressure Response ◽

Plasma Renin ◽

Pressure Response ◽

Renin Activity ◽

Plasma Noradrenaline ◽

Conscious Rabbits ◽

Noradrenaline And Adrenaline

1. Changes in plasma renin activity, plasma noradrenaline and adrenaline, and blood pressure were evaluated after mild haemorrhage (6 ml/kg) and subsequent intravenous captopril in conscious, restrained rabbits. Two protocols were followed. In the first, control animals (n = 8) were compared with rabbits receiving indomethacin (n = 8) in their drinking water for 5 days and intravenously during the haemorrhage and captopril study. In the second protocol, animals receiving propranolol in the drinking water and intravenously (n = 7) were compared with a group (n = 7) receiving propranolol plus indomethacin. 2. Urinary prostaglandin E excretion was decreased significantly with the oral administration of indomethacin in both protocols. Plasma renin activity levels were not significantly different at baseline, but the animals receiving indomethacin had significantly (P < 005) lower values after haemorrhage in both studies. The large increases in plasma renin activity after captopril were not influenced by indomethacin in either study. 3. The blood pressure response to captopril was significantly blunted in the indomethacin group in the first experiment. 4. Plasma noradrenaline and adrenaline levels were not affected by indomethacin treatment in either protocol. 5. It is concluded that the plasma renin activity response to haemorrhage in conscious rabbits is mediated in part by a cyclo-oxygenase-dependent component separable from the β-adrenoceptor. The renin response to converting enzyme inhibition is not influenced by cyclo-oxygenase inhibition. A component of the blood pressure response to captopril may involve a cyclo-oxygenase product.

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The Association of Serum Aldosterone and Plasma Renin Activity with Ambulatory Blood Pressure in African Americans: The Jackson Heart Study

Circulation ◽

10.1161/circulationaha.120.050896 ◽

2021 ◽

Author(s):

Joshua J. Joseph ◽

Neal K. Pohlman ◽

Songzhu Zhao ◽

David Kline ◽

Guy Brock ◽

...

Keyword(s):

Blood Pressure ◽

African Americans ◽

Plasma Renin Activity ◽

Ambulatory Blood Pressure ◽

Plasma Renin ◽

Renin Activity ◽

Masked Hypertension ◽

Jackson Heart Study ◽

Nocturnal Hypertension ◽

Heart Study

Background: The renin-angiotensin-aldosterone system (RAAS) is an important driver of BP but the association of the RAAS with ambulatory blood pressure (ABP) and ABPM phenotypes among African Americans (AA) has not been assessed. Methods: ABP and ABPM phenotypes were assessed in 912 Jackson Heart Study participants with aldosterone and plasma renin activity (PRA). Multivariable linear and logistic regression analysis were used to analyze the association of aldosterone, and PRA with clinic, awake and asleep systolic blood pressure (SBP) and diastolic blood pressure (DBP) and ABPM phenotypes, adjusting for important confounders. Results: The mean age of participants was 59 ±11 years and 69% were female. In fully adjusted models, lower log-PRA was associated with higher clinic, awake, and asleep SBP and DBP (all p<0.05). A higher log-aldosterone was associated with higher clinic, awake, and asleep DBP (all p<0.05). A 1-unit higher log-PRA was associated with lower odds of daytime hypertension (OR: 0.59, 95%CI: 0.49, 0.71), nocturnal hypertension (OR: 0.68, 95%CI: 0.58, 0.79), daytime and nocturnal hypertension (OR: 0.59, 95%CI: 0.48, 0.71), sustained hypertension (OR: 0.52, 95%CI: 0.39, 0.70) and masked hypertension (OR 0.75, 95%CI: 0.62, 0.90). A 1-unit higher log-aldosterone was associated with higher odds of nocturnal hypertension (OR: 1.38, 95%CI: 1.05, 1.81). Neither PRA nor aldosterone were associated with percent dipping, non-dipping BP pattern, or white-coat hypertension. Patterns for aldosterone:renin ratio were similar to PRA. Conclusions: Suppressed renin activity and higher aldosterone:renin ratios were associated with both higher SBP and DBP in the office and during the awake and asleep periods as evidenced by ABPM. Higher aldosterone levels were associated with higher DBP, but not SBP, in the clinic and during the awake and asleep periods. Further clinical investigation of novel and approved medications that target low renin physiology such as epithelial sodium channel inhibitors and mineralocorticoid receptor antagonists may be paramount in improving hypertension control in AAs.

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