Aldosterone-to-Renin Ratio as a Predictor of Stroke Under Conditions of High Sodium Intake: The Ohasama Study
American Journal of Hypertension, 07/05/2012
Satoh M et al. – The results suggest that high aldosterone–to–renin ratio (ARR), that is, relative aldosterone excess, is a predictor for stroke under conditions of high sodium intake.Methods
- The authors obtained plasma renin activity (PRA) and plasma aldosterone concentrations (PAC) for 883 participants aged ≥35 years not receiving antihypertensive treatment in the general population of Ohasama (mean age: 59.0 ± 11.3 years; 65.6% women).
- Over a mean of 10.9 follow-up years, 45 strokes occurred.
- The median PRA, PAC, and ARR were 1.2 ng/ml/h, 6.4 ng/dl, and 5.3 ng/dl per ng/ml/h, respectively.
- Using Cox regression, they computed hazard ratios adjusted for sex, age, body mass index (BMI), and systolic blood pressure.
- No association between logARR and stroke was observed in subjects overall.
- However, in subjects with high sodium intake (≥median of 4,058 mg/day (salt equivalent, 10.5 g/day)), each 1 s.d. increase in logARR was associated with an increased hazard ratio for stroke (hazard ratio: 1.49, P=0.04).
- No significant association was observed in subjects with low sodium intake (P=0.7).
- When they repeated all the analyses using logPRA or logPAC, no significant associations were found.