A6748 The Effect of Physiological Phenotyping with Plasma Renin and Aldosterone on Uncontrolled Hypertension

Abstract

Objectives: We tested the hypothesis that plasma renin and aldosterone level would be as the risk factor of uncontrolled hospitalized hypertensives in China. Methods: Totally 2896 subjects were included at hypertension clinics in Second Affiliated Hospital of Nanchang University from 2012–2017. Plasma renin activity and aldosterone were measured. They are classified into uncontrolled and controlled hypertension group based on a systolic blood pressure > 140 mmHg or diastolic pressure > 90 mmHg who under ≥3 antihypertension drugs treatment or a systolic blood pressure ≤140 mm Hg and diastolic pressure≤90 mmHg by using≥4 drugs as uncontrolled hypertension group, totally 880 subjects, 2009 with controlled hypertension. The differences in group characteristics were compared using ANOVA tests or chi-square tests, accordingly. Logistic regression models were performed to determine the association between renin activity, aldosterone and uncontrolled hypertension. Results: 1)Uncontrolled hypertension group were directly associated with hospitalized SBP, DBP, BMI, triglyceride, homocysteine (tHcy), plasma renin activity (2.3 ± 3.6 vs 1.8 ± 2.8ng/ml/h), aldosterone (16.9 ± 10.9 vs 16.1 ± 11.6ng/dl), and angiotensin II (65.7 ± 52.4 vs 59.9 ± 51.6pg/ml). 2)The plasma renin activity were positively correlated with uncontrolled hypertension group (OR = 1.05; 95% CI: 1.01–1.09; P = 0.012). In the multivariate logistic regression models, compared with participants with plasma renin activity > 1.49 pg/ml/h (OR = 1.39; 95% CI: 1.03–1.87; P = 0.031). And the significantly higher prevalence of uncontrolled hypertension was observed in aldosterone > 17.17ng/dl (OR = 1.26; 95% CI: 1.00–1.60; P < 0.01). Conclusion: Renin/aldosterone phenotyping significantly make the effect in uncontrolled hypertension and no longer only as the lab test of secondary hypertension.