Surprising new data from Sever and colleagues suggest that in patients who have hypertension and cardiovascular disease risk factors, increased plasma renin activity is associated with future renal impairment but not with cardiovascular events or all-cause mortality. These novel data are important but difficult to explain.
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References
Sever, P. S. et al. Is plasma renin activity a biomarker for the prediction of renal and cardiovascular outcomes in treated hypertensive patients? Observations from the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Eur. Heart J. http://dx.doi.org/10.1093/eurheartj/ehs241.
Tigerstedt, R. & Bergman, P. G. Niere und Kreislauf [German]. Skand. Arch. Physiol. 8, 223–271 (1898).
Brunner, H. R. et al. Essential hypertension: renin and aldosterone, heart attack and stroke. N. Engl. J. Med. 286, 441–449 (1972).
Alderman, M. H. et al. Association of the renin–sodium profile with the risk of myocardial infarction in patients with hypertension. N. Engl. J. Med. 324, 1098–1104 (1991).
Sealey, J. E. & Laragh, J. H. Aliskiren, the first renin inhibitor for treating hypertension: reactive renin secretion may limit its effectiveness. Am. J. Hypertens. 20, 587–597 (2007).
Masson, S. et al. Elevated plasma renin activity predicts adverse outcome in chronic heart failure, independently of pharmacologic therapy: data from the Valsartan Heart Failure Trial (Val-HeFT). J. Card. Fail. 16, 964–970 (2010).
Tocci1, G. et al. Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and diabetes: a meta-analysis of placebo-controlled clinical trials. Am. J. Hypertens. 24, 582–590 (2011).
White, H. D. et al. Mortality and morbidity remain high despite captopril and/or valsartan therapy in elderly patients with left ventricular systolic dysfunction, heart failure, or both after acute myocardial infarction: results from the Valsartan in Acute Myocardial Infarction Trial (VALIANT). Circulation 112, 3391–3399 (2005).
ONTARGET Investigators et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N. Engl. J. Med. 358, 1547–1559 (2008).
Schefe, J. H. et al. A novel signal transduction cascade involving direct physical interaction of the renin/prorenin receptor with the transcription factor promyelocytic zinc finger protein. Circ. Res. 99, 1355–1366 (2006).
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Unger, T. Plasma renin activity predicts renal impairment. Nat Rev Nephrol 8, 686–687 (2012). https://doi.org/10.1038/nrneph.2012.243
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DOI: https://doi.org/10.1038/nrneph.2012.243
