E-Poster 63rd Endocrine Society of Australia Annual Scientific Meeting 2020

Correlation between the aldosterone renin ratio and blood pressure in young adulthood -  a longitudinal study (#111)

Jun Yang 1 2 , Stella Gwini 3 , Michael Stowasser 4 , Morag J Young 5 , Peter J Fuller 1 , Markus P Schlaich 6 , Lawrence Beilin 6 , Trevor Mori 6
  1. Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia
  2. Medicine, Monash University, Clayton, VIC, Australia
  3. University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
  4. Faculty of Medicine, University of Queensland, St Lucia, QLD, Australia
  5. Cardiovascular Endocrinology Group, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
  6. Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia

Background: Hypertension tracks throughout childhood into adulthood. Aldosterone excess, or primary aldosteronism, has been reported as the most common secondary cause of hypertension in adults. However, the relationship between aldosterone and blood pressure in childhood is unclear.

Objectives: To evaluate the relationship between aldosterone, renin and the aldosterone:renin ratio (ARR) and blood pressure (BP) at age 17 and 27 in a community-based population.

Design: Prospective pregnancy cohort study.

Participants: Young adult offspring of women enrolled during pregnancy in the Raine Study, who provided blood samples and BP measurements at 17 years (538 males and 335 females not on hormone contraception) and/or 27 years (507 males and 251 females).

Results: At age 17, females had significantly higher aldosterone (median 350 vs 345 pmol/L, p=0.013), lower renin (20.6 vs 25.2 mU/L, p<0.001) and higher ARR (18.4 vs 13.6, p<0.001), but lower systolic BP (108 vs 118 mmHg, p< 0.001) than males. The ARR correlated significantly with systolic BP in males, but not females, at age 17 when adjusted for alcohol consumption, physical activity, urinary sodium:creatinine ratio and body mass index (standardized β-coefficient 0.11, p=0.008). The ARR at age 17 was significantly associated with both systolic (standardized β-coefficient 0.26, p=0.005) and diastolic BP (standardized β-coefficient 0.31, p=0.001) among females, but not males, at age 27.

Conclusion: A robust relationship between ARR and BP exists from a young age, with distinct sex differences.