TARGET LEVELS OF RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM COMPONENTS AND THEIR ROLE IN CARDIOVASCULAR EVENT DEVELOPMENT AMONG PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

The aim of this study was to identify the optimal, characterised by minimal risk of cardiovascular events (CVE), levels of renin-angiotensin-aldosterone system (RAAS) components in patients with arterial hypertension (AH). In total, 454 patients with high-risk AH were examined (age 18-65 years; 92 men, 362 women). Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were assessed by radio-immune method, adrenalin and noradrenalin concentration in 24-hour urine sample – by fluorometric method, left ventricular myocardial structure and function – by echocardiography, renal function – by glomerular filtration rate (Reberg method) and 123 I-Hippuran renography. Target levels of RAAS components were defined as follows: PRA=0,22-3,0 ng/ml/h, if PAC: PRA=5-23 and PAC=0,18- 0,83 nmol/l (5-23 ng/dl). In patients with high CVE risk, the target levels of PRA=0,22-1,0 ng/ml/h and PAC: PRA=5-23 would minimize the risk of stroke, myocardial infarction, and target organ damage.

Keywords

• arterial hypertension
• plasma renin activity
• plasma aldosterone concentration
• myocardial infarction
• stroke