Association of the renin-sodium profile with the risk of myocardial infarction in patients with hypertension
Article Abstract:
High blood pressure is a well established risk factor for heart disease and stroke. However, patients with hypertension are a heterogeneous group, and within this group there is wide variation for both the risk of disease and the response to therapy. Research conducted over 15 years ago indicated that the renin-sodium profile might be an important prognostic determinant of the risk of heart attack in patients with hypertension. In 1981, a study to prospectively confirm the prognostic importance of the renin-sodium profile was begun involving 1,717 patients with mild or moderate hypertension. Renin is a key hormone involved in the regulation of blood pressure, but the absolute renin level in the blood plasma is less informative than the relationship between the plasma level of renin and the rate of excretion of sodium by the kidneys; this is the renin-sodium profile. When the renin-sodium profiles were determined for the study patients, 12 percent were higher than average, 56 percent were classified within the normal ranges, and 32 percent were low. In a period of 8.3 years, 27 heart attacks were observed in the patient population. When the statistics were adjusted for variations due to race and sex, the rate of hear attacks was found to be 14.7 per 1,000 person-years in the high profile group, 5.6 in the normal profile group, and 2.8 among the patients with a low renin-sodium profile. A similar relation was not observed for stroke. When the prognostic value of the renin-sodium profile was compared with other known prognostic indicators such as body-mass index (a measure of obesity), history of cardiovascular disease, high blood sugar or blood pressure, it was found that the renin-sodium index was, in fact, independent of these other factors. It remains to be determined how the renin-sodium profiles measured during treatment might be applied to clinical practice. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1991
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Treatment-induced blood pressure reduction and the risk of myocardial infarction
Article Abstract:
There is agreement that hypertension (elevated blood pressure) is associated with increased risk of stroke and heart attack and that a decrease in high blood pressure through proper drug treatment can prevent some cardiovascular catastrophes. The translation of these widely accepted opinions in clinical practice and treatment is less certain. The study investigates the association between small, moderate and large reductions of blood pressure based on the drug therapy of 1,765 previously untreated hypertensive patients. Three distinct patterns of pressure reduction resulted from this treatment, and each was associated with the risk of myocardial infarction (heart attack). Individuals having either small or large reductions in their blood pressure had the greatest risk of having a heart attack. These data suggest that the current treatment philosophy of reducing the blood pressure to the lowest possible level is incorrect. The moderate reduction of blood pressure as a goal for mild and moderate hypertension should be considered.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
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The association between birthplace and mortality from cardiovascular causes among black and white residents of New York City
Article Abstract:
Higher death rates from heart disease in blacks in New York City compared to whites may be a reflection of their birthplace rather than their race. Researchers used US Census Data and mortality records to compare death rates from cardiovascular disease among blacks and whites in New York City. Blacks born in the Northeast had similar death rates as whites, but blacks born in the South had higher death rates than blacks born in the Northeast. Blacks born in the Caribbean had lower death rates than blacks born in the Northeast. Caribbean-born blacks had lower death rates than whites.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1996
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