Correlation between plasma aldosterone concentration and pulse pressure in patients with essential hypertension in different positions

doi:10.3877/cma.j.issn.1674-0785.2017.13.001

Abstract

Abstract:

Objective

To investigate the correlation between plasma aldosterone concentration (PAC) and pulse pressure (PP) in patients with essential hypertension in different positions.

Methods

A total of 195 patients with hypertension were selected at the Hypertension Center of People′s Hospital of Xinjiang Uygur Autonomous Region from October 2008 to October 2010. All subjects successfully completed stimulation tests in the sitting, supine, and upright positions, and the blood pressure and PAC were measured in the three positions. According to the average pulse pressure, the patients were divided into either a normal PP group (PP < 40 mmHg) or a high PP group (PP ≥ 40 mmHg). Clinical indicators were compared between the two groups. The correlation between PP and aldosterone levels was analyzed.

Results

Serum potassium was significantly higher in the high PP group than in the normal PP group (P = 0.01). Correlation analysis showed that after adjustment of serum potassium, age, and sex, PP was positively correlated with PAC in all the three positions (upright: r = 0.235, P = 0.001; sitting: r = 0.220, P = 0.002; supine: r = 0.166, P = 0.021). Regardless of any position, the level of aldosterone was significantly higher in the high PP group than in the normal PP group. Average PP was significantly higher in patients with PAC > 12 ng/dl in the upright and sitting positions than in those with PAC ≤ 12 ng/dl. A logistics regression model was established by using PP ≥ 40 mmHg as the dependent variable, and age, blood potassium, body mass index, and aldosterone levels in the three position as independent variables. Regression analysis showed that serum K⁺ [OR = 0.043, 95% CI: 1.09 (1.00-1.12)] and PAC [OR = 0.025, 95% CI: 0.35 (0.13-0.88)] were risk factors for increased PP.

Conclusion

There is a positive correlation between serum PAC level and PP, regardless of body position. High level of PAC is a risk factor for arterial elasticity in patients with hypertension.

Key words: Plasma aldosterone, Essential hypertension, Pulse pressure, Different positions

Xiaoguang Yao, Jing Hong, Mei Li, Xiufang Li, Junli Hu, Delian Zhang, Guijuan Chang, Keming Zhou, Nanfang Li. Correlation between plasma aldosterone concentration and pulse pressure in patients with essential hypertension in different positions[J]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(13): 1965-1969.

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References 19

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组别	例数	年龄（岁）	性别（男/女，例）	体重指数（kg/m²）	血清K⁺（ mmol /L）	血清Na⁺（ mmol /L）	血肌酐（ mmol /L）	空腹血糖（ mmol /L）	血胆固醇（ mmol /L）
PP<40 mmHg	70	42.7±8.6	45/25	25.5±3.2	3.99±0.3	141.8±2.2	69.8±18.0	4.81±0.7	4.63±0.9
PP≥40 mmHg	125	43.9±10.8	77/48	26.5±3.8	3.85±0.4	141.3±1.6	72.8±20.6	4.84±0.7	4.45±0.8
检验值		t=0.852	χ²=0.138	t=1.929	t=2.602	t=1.869	t=0.189	t=0.276	t=1.359
P值		0.395	0.71	0.055	0.01	0.063	0.85	0.783	0.176
组别	例数	血三酰甘油（ mmol /L）	高密度脂蛋白（ mmol /L）	低密度脂蛋白（ mmol /L）	24 h平均收缩压（mmHg）	24 h平均舒张压（mmHg）	吸烟[例（%）]	饮酒[例（%）]	高血压病史（年）
PP<40 mmHg	70	2.10±1.8	1.34±0.3	2.59±0.6	126.2±10.2	86.6±9.1	33（47.1）	38（54.3）	3.8±5.8
PP≥40 mmHg	125	2.13±1.4	1.24±0.3	2.46±0.7	145.3±15.0	92.2±12.3	43（34.4）	49（39.2）	4.3±5.9
检验值		t=0.153	t=2.095	t=1.236	t=9.451	t=3.307	χ²=3.063	χ²=4.133	t=0.904
P值		0.878	0.038	0.176	<0.001	<0.001	0.08	0.042	0.611

组别	例数	年龄（岁）	性别（男/女，例）	体重指数（kg/m²）	血清K⁺（ mmol /L）	血清Na⁺（ mmol /L）	血肌酐（ mmol /L）	空腹血糖（ mmol /L）	血胆固醇（ mmol /L）
PP<40 mmHg	70	42.7±8.6	45/25	25.5±3.2	3.99±0.3	141.8±2.2	69.8±18.0	4.81±0.7	4.63±0.9
PP≥40 mmHg	125	43.9±10.8	77/48	26.5±3.8	3.85±0.4	141.3±1.6	72.8±20.6	4.84±0.7	4.45±0.8
检验值		t=0.852	χ²=0.138	t=1.929	t=2.602	t=1.869	t=0.189	t=0.276	t=1.359
P值		0.395	0.71	0.055	0.01	0.063	0.85	0.783	0.176
组别	例数	血三酰甘油（ mmol /L）	高密度脂蛋白（ mmol /L）	低密度脂蛋白（ mmol /L）	24 h平均收缩压（mmHg）	24 h平均舒张压（mmHg）	吸烟[例（%）]	饮酒[例（%）]	高血压病史（年）
PP<40 mmHg	70	2.10±1.8	1.34±0.3	2.59±0.6	126.2±10.2	86.6±9.1	33（47.1）	38（54.3）	3.8±5.8
PP≥40 mmHg	125	2.13±1.4	1.24±0.3	2.46±0.7	145.3±15.0	92.2±12.3	43（34.4）	49（39.2）	4.3±5.9
检验值		t=0.153	t=2.095	t=1.236	t=9.451	t=3.307	χ²=3.063	χ²=4.133	t=0.904
P值		0.878	0.038	0.176	<0.001	<0.001	0.08	0.042	0.611

组别	直立位	坐位	仰卧位
PP<40 mmHg	15.76±8.44	10.84±6.12	5.82±2.61
PP≥40 mmHg	20.43±14.45	13.60±7.96	7.43±5.47
t值	2.679	2.711	2.774
P值	0.008	0.007	0.006

组别	直立位	坐位	仰卧位
PP<40 mmHg	15.76±8.44	10.84±6.12	5.82±2.61
PP≥40 mmHg	20.43±14.45	13.60±7.96	7.43±5.47
t值	2.679	2.711	2.774
P值	0.008	0.007	0.006

体位		24 h-PP	P值
直立位			0.012
	PAC≤12 ng /dl	45.81±7.45
	PAC>12 ng /dl	49.31±9.34
坐位			0.002
	PAC≤12 ng /dl	46.71±7.68
	PAC>12 ng /dl	20.67±10.20
仰卧位			0.004
	PAC≤6 ng /dl	46.49±8.78
	PAC>6 ng /dl	50.16±8.75

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