A Trend of Plasma Renin Activity among Hypertensive Patients in Basra

Abstract

1.1. Background: Measurement of plasma renin activity in hypertensive patients is of value in deciding the specific antihypertensive drugs for certain patient's characteristics and in resistant hypertension where it can diagnose different form of secondary hypertension. Certain patient's variables affect plasma renin level. 1.2. Objective:To study the relation of many variables with the plasma renin activity among hypertensive patients e.g. patients age, gender, body weight, race, smoking, type & duration of hypertension, comorbidity, controllable state and serum potassium level. 1.3. Patients andMethods: A cross sectional study was performed on patients with hypertension attends the private clinic, outpatient's clinic and medical ward in Basra for the period of June 2011 to the June 2012. 1.4. Result: The study involved 144 patients. Eighty four (58.3%) patients were male and 60(41.7%) patients were female with an age range of 18-78 years and a mean age of 43.5 +/- 13 SD. Twenty four (16.7%) patients were less than 30 years old, 107(74.3%) patients were between 31-60 years and 13(9%) patients were more than 61 years. Twenty two (15.3%) patients were black and 122(84.7%) were white. Nine (6.3%) patients were obese, 59(41%) were overweight and 76(52.8%) were of normal weight. One hundred twenty four (86.7%) patients have no comorbidity, 7(4.9%) have diabetes, 4(2.8%) have CKD, 6(4.2%) have IHD and 2(1.4%) have stroke. Thirty nine (27.1%) patients were smoker and the rest were non smokers. In all age groups, the plasma renin was frequently high, 58.3 % in age group less than 30 years, 62.2% in age 31-60 years and 61.5% in over 61 years old but no statistical significant correlation (Pearson value = 0.931). In both genders, the plasma renin was frequently high 64.3% in male and 58.3% in female but there is no statistical significant correlation (Pearson value = 0.313). In all BMI groups, the plasma renin was frequently high 57.9% in normal weight, 67.8% in overweight and 55.6% in obese but there is no statistical significant correlation (Pearson value = 0.583). In regard to the race, 68.2% black patients have low plasma renin and 68% white patients have high plasma renin which was statistically significant (Pearson value = 0.000). The plasma renin was high both in hypertension less than 3 years (61.8%) and more than 3 years (61.9%) which was statistically non significant correlation (Pearson value = 0.988). In essential hypertension, 10.5% patients have low renin, 27.4% have normal renin and 62.1% have high renin. In comparison with secondary hypertension, there is no statistical significant correlation (Pearson value = 0.972). The plasma renin was high more frequently in systolic (63.6%), diastolic (58.6%) and systolic and diastolic (62.5%) hypertension but there is no statistical significant correlation (Pearson = 0.350). The plasma renin was high more frequently in smokers (61.5%) and non smokers (61.9%) but no statistical significant correlation (Pearson value = 0.360). 1.5. Conclusion: Many variables may affect the plasma renin which in turn guides the specific antihypertensive drugs. High plasma renin was more common in almost all variables and variables subgroups except in black races where the plasma renin is low. There is no significant statistical correlation between plasma renin and age, gender, BMI, duration of hypertension, type of hypertension and type of dominant blood pressure elevation. Smoking has no effect on plasma renin.