Relation of the renin–angiotensin–aldosterone system with potential cardiac injury and remodelling: the SABPA study. (2nd January 2020)

• Record Type: Journal Article
• Authors: Gafane-Matemane, Lebo F.; Mokae, Nametsegang L.; Breet, Yolandi; Malan, Leone
• Is Part Of: Blood pressure. Volume 29:Number 1(2020)
• Page Start: 31
• Page End: 38
• Publication Date: 2020-01-02
• Subjects: Cardiac injury -- cardiac troponin T -- cardiac remodelling -- NTproBNP -- renin -- aldosterone -- copeptin; Blood pressure -- Periodicals; Hypertension -- Periodicals; Hypertension -- Periodicals; Blood Pressure -- Periodicals; 612.14
• DOI: 10.1080/08037051.2019.1645587
• Languages: English
• ISSNs: 0803-7051

Abstract

Abstract: Purpose: The renin-angiotensin-aldosterone system (RAAS) plays an important role in maintaining hemodynamic homeostasis. Ethnic disparities exist regarding RAAS activity due to sympathetic activity and sodium-water retention, however the implications thereof on cardiac damage is unknown. This study investigated the associations of cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide (NTproBNP) and subclinical LVH with components of the RAAS (renin, aldosterone and aldosterone-to-renin ratio (ARR)) and copeptin in a black and white South African cohort. Materials and methods: The study population consisted of 305 participants (black = 139, white = 166) aged 20–62 years. Serum cTnT, NTproBNP, Cornell product, components of the RAAS (active renin, aldosterone and ARR) and copeptin were determined. Results: The black group had lower renin ( p < 0.001) and higher ARR ( p < 0.001), cTnT ( p = 0.015) and Cornell product compared to whites (all p < 0.001). NTproBNP and copeptin were similar between the groups. After forward stepwise adjustments for multiple confounders, inverse associations of cTnT with renin ( β = −0.17, p = 0.018) and aldosterone ( β = −0.14, p = 0.048) as well as an inverse association between NTproBNP and aldosterone ( β = −0.25, p < 0.001) were observed in the white population only. In the black group cTnT associated positively with renin ( β = 0.16, p = 0.040) and copeptin ( β = 0.21, p = 0.020) and inversely with ARR ( β = −0.15, p = 0.047). Additionally, NTproBNP associated positively with copeptin ( β = 0.18, p = 0.045). No correlations were observed between the RAAS and Cornell product in any of the groups. Conclusions: Our findings suggest that RAAS, together with cardiac stress may function differently in cardiac damage and remodelling in the two ethnic groups; which may influence treatment in clinical practice.