PP.08.25: SEVERITY OF LEFT VENTRICULAR REMODELLING IS ASSOCIATED WITH RENIN-MEDIATED ARTERIAL HYPERTENSION. (June 2015)

• Record Type: Journal Article
• Authors: Kravtsova, O.; Kotovskaya, Y.; Dmitrova, T.; Khodorovich, N.; Safarova, A.; Kobalava, Z.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000467977.46253.7b
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Plasma renin activity (PRA) measurement is an approach to guide antihypertensive treatment. RAAS blockers are effective in renin-mediated hypertension, whereas anti-volume drugs (e.g. diuretics or calcium channel blockers) - in low-renin hypertension. RAAS-blockers have proven their ability to regress left ventricular hypertrophy (LVH). The aim of study was to compare LV characteristics in subjects with low-renin and renin-mediated hypertension to confirm potential benefits of this treatment approach. Design and method: PRA (radioimmune assay) was measured in 72 hypertensive subjects (age 61, 1 ± 7, 6 years, 30 male). PRA < 0, 65 ng/ml/h was classified as volume (V)-type hypertension, PRA > 0, 65 ng/ml/h - as renin (R)-type. Echocardiographic parameters of LV remodelling and its function were compared in subjects with two types of hypertension. LVH criteria were: LV mass index (LVMI) > 125 g/m 2 in males and > 110 g/m 2 in females. p < 0, 05 was considered significant. Results: 42 (58%) subjects had V-type hypertension, 30 (42%) - R-type. Despite patients with V-type hypertension were older (respectively, 63, 1 ± 9, 1 vs 60, 3 ± 6, 4 years, p < 0, 05) and had higher systolic and diastolic BP (162, 6 ± 14, 1/103, 7 ± 11, 5 vs 157, 9 ± 17, 1/95, 0 ± 7, 8 mmHg), respectively, p < 0, 05). Patients with R-type hypertension vs those with V-type had significantly (p < 0, 05) larger left atrium diameter (3, 9 ± 0, 4 vs 3, 7 ± 0, 5 cm) and its volume index (39, 1 ± 7, 3 vs 36, 2 ± 7, 4 ml/m2), relative wall thickness (0, 63 ± 0, 12 vs 0, 57 ± 0, 11), LVMI (145, 9 ± 35, 6 vs 134, 3 ± 38, 4 g/m 2 ), deceleration time (256, 3 ± 55, 8 vs 179, 4 ± 40, 3 ms), E/È (12, 4 ± 5, 8 vs 10, 9 ± 4, 0) and LVH prevalence (93% vs 62%). Multivariate logistic analysis revealed independent association between PRA and LVMI (β=0, 78, p < 0, 001) and diastolic function characteristics E/A (β = −0, 49, p < 0, 001), isovolumic relaxation time (β = 0, 34, p < 0, 001), deceleration time (β = 0, 74, p < 0, 001), E/È (β=0, 68, p < 0, 001). Conclusions: Renin-mediated arterial hypertension is associated with adverse LV remodelling and diastolic dysfunction in hypertensive subjects. The finding confirms choice of RAAS-blockers as a beneficial therapeutic approach in those subjects to decrease BP and achieve LVH regression