Racial differences in sensitivity of blood pressure to aldosterone

Wanzhu Tu, George J. Eckert, Tamara S. Hannon, Hai Liu, Linda M. Pratt, Mary Anne Wagner, Linda A. DiMeglio, Jeesun Jung, J. Howard Pratt

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Abstract

Blacks in comparison with whites are at risk for a more serious form of hypertension with high rates of complications. Greater sodium retention is thought to underlie the blood pressure (BP)-determining physiology of blacks, but specific mechanisms have not been identified. In a prospective observational study of BP, 226 black children and 314 white children (mean age, 10.6 years) were enrolled initially. Assessments were repeated in 85 blacks and 136 whites after reaching adulthood (mean age, 31 years). The relationship of BP to plasma aldosterone concentration in the context of the prevailing level of plasma renin activity was studied in blacks and whites. In a secondary interventional study, 9-α fludrocortisone was administered for 2 weeks to healthy adult blacks and whites to simulate hyperaldosteronism. BP responses in the 2 race groups were then compared. Although black children had lower levels of plasma renin activity and plasma aldosterone, their BP was positively associated with the plasma aldosterone concentration, an effect that increased as plasma renin activity decreased (P=0.004). Data from black adults yielded similar results. No similar relationship was observed in whites. In the interventional study, 9-α fludrocortisone increased BP in blacks but not in whites. In conclusion, aldosterone sensitivity is a significant determinant of BP in young blacks. Although its role in establishing the risk of hypertension is not known, it could be as relevant as the actual level of aldosterone.

Original languageEnglish (US)
Pages (from-to)1212-1218
Number of pages7
JournalHypertension
Volume63
Issue number6
DOIs
StatePublished - Jun 2014

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Keywords

  • Aldosterone
  • Blood pressure
  • Child
  • Continental population groups
  • Renin
  • Sodium

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Tu, W., Eckert, G. J., Hannon, T. S., Liu, H., Pratt, L. M., Wagner, M. A., DiMeglio, L. A., Jung, J., & Pratt, J. H. (2014). Racial differences in sensitivity of blood pressure to aldosterone. Hypertension, 63(6), 1212-1218. https://doi.org/10.1161/HYPERTENSIONAHA.113.02989