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Associations of central and peripheral blood pressure with the renin-angiotensin-aldosterone system in healthy young adults: the African-PREDICT study

Hypertension Research volume 44, pages 435–445 (2021)Cite this article

Abstract

This study investigated associations of brachial and central blood pressure (BP) with detailed renin-angiotensin-aldosterone system (RAAS) components in a healthy young population stratified according to ethnicity and sex. We included healthy black men (n = 285) and women (n = 304) and white men (n = 278) and women (n = 305) aged 20–30 years old. We derived central systolic BP (cSBP), measured clinic and 24-h systolic and diastolic BP. Aldosterone and equilibrium angiotensin levels were assessed and used for calculating angiotensin-derived markers for plasma renin activity (PRA-S, Angiotensin I + Angiotensin II), angiotensin-converting enzyme (ACE-S, Angiotensin II/Angiotensin I), and two markers for adrenal effects of angiotensin II, the aldosterone-to-renin ratio (ARR-S, Aldosterone/PRA-S) and the aldosterone-to-angiotensin II-ratio (AA2-R, Aldosterone/Angiotensin II). Young black men and women presented with lower RAAS components and higher cSBP compared to their white counterparts (all p ≤ 0.001). In multivariable-adjusted regression analyses, positive associations of cSBP with ARR-S and AA2-R and negative associations with PRA-S and angiotensin II were found for black women (all p ≤ 0.001); this pattern was also observed for 24-h and clinic BP (p ≤ 0.045). A similar trend of RAAS associations was present in black men but only for clinic BP (all p ≤ 0.047). In white men, negative associations between clinic SBP and PRA-S, angiotensin II and aldosterone were detected (all p ≤ 0.048). No associations were observed in white women. Positive associations of central and peripheral BP with the ratio of aldosterone to PRA-S and angiotensin II only in healthy, young black adults suggest that relative aldosterone excess may contribute to early hypertension development in this group.

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Acknowledgements

The authors are grateful to all individuals participating voluntarily in the study. The dedication of the support and research staff as well as students at the Hypertension Research and Training Clinic at North-West University are also duly acknowledged. The research funded in this manuscript is part of an ongoing research project financially supported by the South African Medical Research Council (SAMRC) with funds from the National Treasury under its Economic Competitiveness and Support Package; the South African Research Chairs Initiative (SARChI) of the Department of Science and Technology and National Research Foundation (NRF) of South Africa (GUN 86895); SAMRC with funds received from the South African National Department of Health, GlaxoSmithKline R&D (Africa Non-Communicable Disease Open Lab grant), the UK Medical Research Council and with funds from the UK Government’s Newton Fund; as well as corporate social investment grants from Pfizer (South Africa), Boehringer-Ingelheim (South Africa), Novartis (South Africa), the Medi Clinic Hospital Group (South Africa) and in kind contributions of Roche Diagnostics (South Africa). Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors, and therefore, the NRF does not accept any liability in this regard. Research reported in this publication was supported by the South African Medical Research Council under a Self-Initiated Research Grant. The views and opinions expressed are those of the author(s) and do not necessarily represent the official views of the SAMRC.

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Authors and Affiliations

  1. Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa

    Lebo F. Gafane-Matemane, Nametsegang L. Mokae, Yolandi Breet & Aletta E. Schutte

  2. Medical Research Council, Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa

    Lebo F. Gafane-Matemane, Nametsegang L. Mokae, Yolandi Breet & Aletta E. Schutte

  3. Attoquant Diagnostics, Vienna, Austria

    Marko Poglitsch

  4. School of Population Health, University of New South Wales, Sydney, NSW, Australia

    Aletta E. Schutte

  5. The George Institute for Global Health, Sydney, NSW, Australia

    Aletta E. Schutte

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  1. Lebo F. Gafane-Matemane
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Correspondence to Lebo F. Gafane-Matemane.

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Gafane-Matemane, L.F., Mokae, N.L., Breet, Y. et al. Associations of central and peripheral blood pressure with the renin-angiotensin-aldosterone system in healthy young adults: the African-PREDICT study. Hypertens Res 44, 435–445 (2021). https://doi.org/10.1038/s41440-020-00566-1

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