Features of the Activity of Separate Components of the Renin-Angiotensin-Aldosterone System in Arterial Hypertension and Concomitant Obesity

Renin-angiotensin-aldosterone system plays a key role in the blood pressure regulation. The study of the activity of such components of the renin-angiotensin-aldosterone system as renin and aldosterone, as well as their ratio in hypertensive patients, depending on the presence and absence of obesity, is an acute problem that requires further study. The purpose of the study was to evaluate the content of aldosterone, renin and their ratio in arterial hypertension and concomitant obesity. Material and methods. The study included 188 patients with arterial hypertension. The first group consisted of 107 patients with obesity of I-II degrees, the second group had 40 patients with overweight, the third group included 41 patients with normal body weight. The control group consisted of 25 practically healthy individuals. The concentrations of aldosterone and renin in serum were determined. At the renin levels <0.65 ng/ml/h, low-renin hypertension was established, and the renin levels ≥ 0.65 ng/ml/h, high-renin hypertension was established. Results and discussion. The patients with concomitant obesity had a significantly lower incidence of low-renin hypertension compared to hypertensive patients with normal body weight and overweight. Hypertensive patients with different body mass had significantly higher aldosterone and renin levels compared to the control group (in the absence of differences in aldosterone-renin ratio). At the same time hypertensive patients with different body mass were not significantly different as to the indicated parameters. Patients with low-renin and high-renin arterial hypertension did not differ significantly in age, sex, and anthropometric indices; however, low-renin hypertensive patients had a significantly lower aldosterone serum and a significantly higher aldosterone-renin ratio in comparison with high-renin hypertensive patients. Conclusions. In hypertensive patients, obesity is associated with a lower incidence of low-renin hypertension compared to patients with normal body weight and overweight. We found no differences in anthropometric indices in low-renin and high-renin arterial hypertension, in the presence of differences in levels of renin, aldosterone and aldosterone-renin ratio