Baseline serum aldosterone-to-renin ratio is associated with the add-on effect of thiazide diuretics in non-diabetic essential hypertensives

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

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)37-48
Number of pages12
JournalActa Cardiologica Sinica
Volume29
Issue number1
Publication statusPublished - Jan 2013
Externally publishedYes

Keywords

  • Add-on
  • Aldosterone-to-renin ratio
  • Blood pressure
  • Hydrochlorothiazide
  • Hypertension
  • Renin
  • Thiazide

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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