The relationship between plasma renin activity and serum lipid profiles in patients with primary arterial hypertension

Introduction: The aim of the study was to evaluate clinical and biochemical differences between patients with lowrenin and high-renin primary arterial hypertension (AH), mainly in reference to serum lipids, and to identify factors determining lipid concentrations. Materials and methods: In untreated patients with AH stage 1 we measured plasma renin activity (PRA) and subdivided the group into low-renin (PRA < 0.65 ng/mL/h) and high-renin (PRA ⩾ 0.65 ng/mL/h) AH. We compared office and 24-h ambulatory blood pressure, serum aldosterone, lipids and selected biochemical parameters between subgroups. Factors determining lipid concentration in both subgroups were assessed in regression analysis. Results: Patients with high-renin hypertension (N = 58) were characterized by higher heart rate ($\rho$ = 0.04), lower serum sodium ($\rho$ < 0.01) and aldosterone-to-renin ratio ($\rho$ < 0.01), and significantly higher serum aldosterone ($\rho$ = 0.03), albumin ($\rho$ < 0.01), total protein ($\rho$ < 0.01), total cholesterol ($\rho$ = 0.01) and low-density lipoprotein cholesterol (LDL-C) ($\rho$ = 0.04) than low-renin subjects (N = 39). In univariate linear regression, only PRA in the low-renin group was in a positive relationship with LDL-C ($R^{2}$ = 0.15, $\beta$ = 1.53 and $\rho$ = 0.013); this association remained significant after adjustment for age, sex, and serum albumin and aldosterone concentrations. Conclusions: Higher serum levels of total and LDL-C characterized high-renin subjects, but the association between LDL-C level and PRA existed only in low-renin primary AH.