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Aldosterone-to-Renin Ratio Is Associated With Reduced 24-Hour Heart Rate Variability and QTc Prolongation in Hypertensive Patients
Gruebler, Martin R. ;  Kienreich, Katharina ;  Gaksch, Martin ;  Verheyen, Nicolas ;  Hartaigh, Briain O. ;  Fahrleitner-Pammer, Astrid ;  Maerz, Winfried ;  Schmid, Johannes ;  Oberreither, Eva-Maria ;  Wetzel, Julia ;  Catena, Cristiana ;  Sechi, Leonardo A. ;  Pieske, Burkert ;  Tomaschitz, Andreas ;  Pilz, Stefan

HaupttitelAldosterone-to-Renin Ratio Is Associated With Reduced 24-Hour Heart Rate Variability and QTc Prolongation in Hypertensive Patients
AutorGruebler, Martin R.
AutorKienreich, Katharina
AutorGaksch, Martin
AutorVerheyen, Nicolas
AutorHartaigh, Briain O.
AutorFahrleitner-Pammer, Astrid
AutorMaerz, Winfried
AutorSchmid, Johannes
AutorOberreither, Eva-Maria
AutorWetzel, Julia
AutorCatena, Cristiana
AutorSechi, Leonardo A.
AutorPieske, Burkert
AutorTomaschitz, Andreas
AutorPilz, Stefan
Seitenzahl7 S.
DDC610 Medizin und Gesundheit
Auch erschienen inMedicine. - 95 (2016), 8, Artikel Nr. p e2794
ZusammenfassungAldosterone is considered to exert direct effects on the myocardium and the sympathetic nervous system. Both QT time and heart rate (HR) variability (HRV) are considered to be markers of arrhythmic risk and autonomous dysregulation. In this study, we investigated the associations between aldosterone, QT time, and HRV in patients with arterial hypertension.

We recruited 477 hypertensive patients (age: 60.2 ± 10.2 years; 52.3% females) with a mean systolic/diastolic 24-hour ambulatory blood pressure monitoring (ABPM) value of 128 ± 12.8/77.1 ± 9.2 mmHg and with a median of 2 (IQR: 1–3) antihypertensive agents. Patients were recruited from the outpatient clinic at the Department of Internal Medicine of the Medical University of Graz, Austria. Blood samples, 24-hour HRV derived from 24-hour blood pressure monitoring (ABPM) and ECG's were obtained. Plasma aldosterone and plasma renin concentrations were measured by means of a radioimmunoassay. Twenty-four-hour urine specimens were collected in parallel with ABPM.

Mean QTc was 423.3 ± 42.0 milliseconds for males and 434.7 ± 38.3 milliseconds for females. Mean 24H-HR and 24H-HRV was 71.9 ± 9.8 and 10.0 ± 3.6 bpm, respectively. In linear regression analyses adjusted for age, sex, body mass index, ABPM, and current medication, aldosterone to active renin ratio (AARR) was significantly associated with the QTc interval, a marker for cardiac repolarization abnormalities (mean = 426 ± 42.4 milliseconds; β-coefficient = 0.121; P = 0.03) as well as with the 24-hour heart rate variability a surrogate for autonomic dysfunction (median = 9.67 [IQR = 7.38–12.22 bpm]; β-coefficient = −0.133; P = 0.01).

In hypertensive patients, AARR is significantly related to QTc prolongation as well as HRV. Further studies investigating the effects of mineralocorticoid receptor blocker and aldosterone synthase inhibitors on QTc and HRV are warranted.
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Fachbereich/EinrichtungMedizinische Fakultät Charité - Universitätsmedizin Berlin
Erscheinungsjahr2016
Dokumententyp/-SammlungenWissenschaftlicher Artikel
SpracheEnglisch
RechteCreative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Anmerkungen des AutorsDer Artikel wurde in einer Open-Access-Zeitschrift publiziert.
Erstellt am07.07.2016 - 08:35:28
Letzte Änderung07.07.2016 - 08:36:34
 
Statische URLhttp://edocs.fu-berlin.de/docs/receive/FUDOCS_document_000000024954
DOI10.1097/MD.0000000000002794
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