Association between plasma renin activity and metabolic cardiovascular risk factors in essential hypertension

Objectives. To study the relationships between plasma renin activity and metabolic cardiovascular risk factors in patients with essential hypertension. Subjects and design. Patients with uncomplicated essential hypertension (n = 36) with a diastolic blood pressure of 95-115 mmHg were studied. Assessment of plasma renin activity (PRA) related to urinary sodium excretion was used to define subgroups with high (n = 12), medium (n = 16) and low renin profiles (n = 8). Main outcome measures. Easting plasma lipid levels were determined. Glucose, insulin and C-peptide responses to standard oral glucose tolerance test (OGTT) were measured. Results. Patients with high PRA had higher levels of plasma cholesterol (6.13 +/- 0.81 versus 4.67 +/- 0.7 mmolL(-1), P < 0.05) and triglycerides (2.14 +/- 0.18 versus 0.98 +/- 0.13 mmolL(-1), P < 0.05), than the low PRA group. HDL-cholesterol levels were lower in the high renin group than in the low renin group (1.05 +/- 0.04 versus 1.26 +/- 0.09 mmolL(-1), P < 0.05). Insulin and C-peptide sums were higher in high PRA group (33.8 +/- 1.2 versus 25.1 +/- 0.9 and 2.6 +/- 0.3 versus 1.9 +/- 0.4 ng L(-1), P < 0.05), than in the low PRA group. Conclusions. Essential hypertensive patients with a high renin profile display more pronounced dyslipidaemia and higher levels of plasma insulin than patients with a low renin profile. This may be one explanation for higher incidence of cardiovascular disease previously reported in high PRA group.