European Heart Journal Advance Access originally published online on September 25, 2007
European Heart Journal 2007 28(21):2644-2652; doi:10.1093/eurheartj/ehm399
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Plasma renin and risk of cardiovascular disease and mortality: the Framingham Heart Study
1 Framingham Heart Study, Boston University School of Medicine, 73 Mount Wayte Avenue, Suite 2, Framingham, MA 01702-5803, USA
2 Division of Cardiology, Massachusetts General Hospital, USA
3 Department of Mathematics and Statistics, Boston University, Boston, MA, USA
4 Boston University, Boston, MA, USA
5 The National Heart, Lung and Blood Institute, Bethesda, MD, USA
6 Preventive Medicine and Cardiology Sections, Boston University School of Medicine, Boston, MA, USA
Received 19 March 2007; revised 13 August 2007; accepted 24 August 2007; online publish-ahead-of-print 25 September 2007.
* Corresponding author. Tel: + 1 508 935 3450; fax: + 1 508 626 1262. E-mail address: vasan{at}bu.edu
See page 2557 for the editorial comment on this article (doi:10.1093/eurheartj/ehm371)
Aims: Previous studies relating plasma renin to cardiovascular disease (CVD) and mortality yielded conflicting results. We related plasma renin to incidence of CVD and mortality in 3408 individuals (mean age 59; 53% women) and in a hypertensive subset (n = 1413).
Methods and results: On follow-up (mean 7.1 years), 176 participants (122 hypertensives) developed CVD and 215 individuals (127 hypertensives) died. Overall, log-renin was associated with mortality [multivariable-adjusted hazards ratio (HR) per SD increment: in whole sample, 1.14, 95% confidence interval (CI) 1.00–1.30, P = 0.046; hypertensives, 1.16, 95% CI 1.00–1.35, P = 0.046], but relations varied over time (P < 0.02). Log-renin was associated with mortality at 2.5 years of follow-up (HR per SD increment: whole sample at 2.5 years, 1.23, 95% CI 1.04–1.45; hypertensives at 2 years, 1.28, 95% CI 1.06–1.54), but not during longer follow-up (HR per SD increment at 5 years: whole sample, 1.02, 95% CI 0.80–1.29; hypertensives, 0.98, 95% CI 0.74–1.30). The time-dependent relation of renin and mortality risk was maintained upon excluding participants with prevalent CVD. Renin was not associated with CVD incidence (HR per SD increment log-renin: whole sample, 0.99, 95% CI 0.85–1.14; hypertensives, 0.96, 95% CI 0.82–1.12).
Conclusion: Higher plasma renin was associated with greater short-term mortality but not with CVD incidence in the community.
Key Words: Renin • Cardiovascular disease • Hypertension • All-cause mortality • Epidemiology
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