Correlates of blood pressure differ in high and in low plasma renin groups

It has been proposed that the aetiology, pathophysiological status, and effective treatment of hypertensives depends on concomitant plasma renin levels. Epidemiological data are scarce on the interrelations of plasma renin activity (PRA), BP and correlates of BP in the general population. Therefore, profiles of BP correlates were compared between low PRA groups and high PRA groups in a relatively healthy population of 321 Chinese government employees working in the Taipei area, in the summer of 1987. The characteristics of the two PRA groups were similar in body mass index, urinary sodium, chloride, calcium excretion and fasting parathyroid hormone. However, the high PRA group was younger, smoked more, and had a higher mean urinary potassium excretion. Fasting plasma glucose, uric acid, and creatinine levels were lower in the low PRA group. Positive relationships between BP and urinary sodium, chloride, potassium, calcium, plasma cholesterol, triglyceride, and glucose, independent of age and body mass index, were demonstrated in the low PRA group, where a volume expansion state may exist. However, in the high PRA state, uric acid, haemoglobin concentration, insulin and parathyroid hormone level were correlated more closely with BP than in the low PRA state. Further studies are needed to examine whether the differing associations between BP and risk factors in the high and low PRA groups reflect different compensatory mechanisms or aetiological factors.