Evaluation of Active Renin Concentration in A Cohort of Adolescents with Primary Hypertension

Anna Deja, Piotr Skrzypczyk, Magdalena Nowak, Małgorzata Wrońska, Michał Szyszka, Anna Ofiara, Justyna Lesiak-Kosmatka, Anna Stelmaszczyk-Emmel, Małgorzata Pańczyk-Tomaszewska, Anna Deja, Piotr Skrzypczyk, Magdalena Nowak, Małgorzata Wrońska, Michał Szyszka, Anna Ofiara, Justyna Lesiak-Kosmatka, Anna Stelmaszczyk-Emmel, Małgorzata Pańczyk-Tomaszewska

Abstract

Our study aimed to assess active renin concentration in children with primary hypertension. Thus, we evaluated active renin concentration, clinical parameters, office and ambulatory blood pressure, and biochemical parameters in 51 untreated adolescents with primary hypertension (median: 14.4 [interquartile range-IQR: 13.8-16.8] years) and 45 healthy adolescents. Active renin concentration did not differ between patients with hypertension and healthy children (median: 28.5 [IQR: 21.9-45.2] vs. 24.9 [IQR: 16.8-34.3] [pg/mL], p = 0.055). In the whole group of 96 children, active renin concentration correlated positively with serum potassium and office and ambulatory systolic and diastolic blood pressures. Among children with hypertension, patients with isolated systolic hypertension had lower renin concentration than patients with systolic-diastolic hypertension (26.2 [IQR: 18.6-34.2] vs. 37.8 [IQR: 27.0-49.6] [pg/mL], p = 0.014). The active renin concentration did not differ between patients with isolated systolic hypertension and healthy children. In multivariate analysis, diastolic blood pressure Z-score (beta = 0.238, 95 confidence interval [0.018-0.458], p = 0.035) was the only predictor of active renin concentration in the studied children. We concluded that active renin concentration is positively associated with blood pressure and potassium in children, and diastolic blood pressure was the strongest predictor of renin level. Patients with isolated systolic hypertension may differ from patients with systolic-diastolic hypertension in less severe activation of the renin-angiotensin-aldosterone system.

Keywords: blood pressure; children; isolated systolic hypertension; primary hypertension; renin; renin-angiotensin-aldosterone system.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Active renin concentration in healthy children, in children with isolated systolic hypertension, and with systolic-diastolic hypertension (ISH—isolated systolic hypertension).
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve for active renin concentration and the presence of primary hypertension (ROC—receiver operating characteristics).
Figure 3
Figure 3
Receiver operating characteristic (ROC) curve for active renin concentration and the presence of systolic-diastolic hypertension (ROC—receiver operating characteristics).

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Source: PubMed

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