ASSOCIATIONS BETWEEN CIRCULATING COMPONENTS OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM AND LEFT-VENTRICULAR MASS

Objective-Cardiac growth may be modulated in part by the trophic effec ts of neurohormones, The aim of the present study was to investigate t he relation between the basal activity of the renin-angiotensin-aldost erone system and left ventricular mass. Design-A population based samp le of 615 middle-aged subjects was studied by standardised echocardiog raphy; anthropometric measurements; and biochemical quantification of renin, pro-renin, angiotensinogen, angiotensin converting enzyme (ACE) , and aldosterone. Results-Echocardiographic left ventricular mass ind ex correlated significantly with arterial blood pressure, age, and bod y mass index. In addition, ire. men ACE activity was significantly rel ated to left ventricular mass index in univariate (P = 0.0007) and mul tivariate analyses (P = 0.008). Men with left ventricular hypertrophy presented with significantly higher serum ACE concentrations than thos e with normal left ventricular mass index (P = 0.002). In both men and women serum aldosterone was strongly related to septal and posterior wall thickness. Furthermore, in women serum aldosterone was positively and independently associated with left ventricular mass index (P = 0. 0001). This effect was most prominent in hypertensive women. Finally, women with left ventricular hypertrophy presented with significantly h igher serum aldosterone (P = 0.01). No significant associations with l eft ventricular mass index were observed for angiotensinogen, renin, o r pro-renin. Conclusions-The data suggest that the variability of seru m AGE or aldosterone, as occurred in this large population based sampl e, may contribute to the modulation of left ventricular mass.