The relationship of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension

Yang Liu,Yao Lin,Jing Zhao,Xiao-Hui Li,Yan-Yan Liu,Ming-Ming Zhang,Lin Shi

doi:10.1186/s12872-020-01579-x

Yang Liu, Yao Lin + Show 5 more

Open Access

https://doi.org/10.1186/s12872-020-01579-x

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Abstract

BackgroundTo investigate the relationships of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension.MethodsA case-control study was conducted on 132 children diagnosed with essential hypertension (103 males and 29 females with the mean age of 11.8 ± 2.4 years). The plasma RAAS levels were measured using the enhanced chemiluminescence method, the ambulatory blood pressure was monitored for 24 h, and then the average real variability (ARV) was calculated. Data on indicators were used for assessing cardiac and renal damages. The correlations of plasma renin, angiotensin, and aldosterone (RAAS) levels to blood pressure variability (BPV) and target organ damage (TOD) were studied. A comparison between the groups was conducted using SPSS 20.ResultsAmong the 132 children, 55 cases had target organ damage. The 24-h ARV and the daytime ARV of the systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.175, P = 0.031; t = 2.672, P = 0.009). Plasma AT II and aldosterone levels were significantly associated with the left ventricular mass index (r = 0.329, P = 0.0001; r = 0.175, P = 0.045). Linear regression analysis showed that AT II [β ± s.e. = 0.025 ± 0.006, 95% CI (0.013–0.038), P = 0.0001] and aldosterone [β ± s.e. = 0.021 ± 0.007, 95% CI (0.008–0.034), P = 0.002] were risk factors for LVH.ConclusionsThe AT II level in children with essential hypertension affected the variability of the 24-h and the daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage. Results from this study indicated that AT II and aldosterone are risk factors for LVH in childhood hypertension and are of great significance for improving the clinical prognosis of pediatric patients with hypertension.

Highlights

To investigate the relationships of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension
Over-activation of renin-angiotensin-aldosterone system (RAAS) plays an important role in the pathogenesis of hypertension [1]
In conclusion, RAAS plays an important role in the pathogenesis of hypertension

Summary

Introduction

To investigate the relationships of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension. Ambulatory blood pressure monitoring (ABPM) has been extensively used to monitor 24-h blood pressure changes in hypertensive patients to reveal blood pressure variability (BPV), which refers to the fluctuation of blood pressure over a period of time It is an objective indicator of blood pressure stability and is affected by many factors. Several studies have demonstrated that the components of the RAAS, both angiotensin II and aldosterone, are associated with BPV and involved in the progression of hypertensive target organ damage and cardiovascular diseases in adults [7,8,9]

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