Aldosterone and renin concentrations and blood pressure in young Indigenous and non-Indigenous adults in the Northern Territory: A cross-sectional study

Elisabeth Ng; Stella M. Gwini; Michael Stowasser; Morag J. Young; Peter J. Fuller; Gurmeet R. Singh; Jun Yang

doi:10.5694/mja2.52062

Aldosterone and renin concentrations and blood pressure in young Indigenous and non-Indigenous adults in the Northern Territory: A cross-sectional study

Elisabeth Ng
, Stella M. Gwini
, Michael Stowasser
, Morag J. Young
, Peter J. Fuller
, Gurmeet R. Singh
, Jun Yang

Menzies School of Health Research

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Objectives: To evaluate aldosterone and renin levels and aldosterone-to-renin ratios (ARRs) in young Indigenous and non-Indigenous adults in the Northern Territory, and their association with blood pressure levels.

Design: Cross-sectional study; single time point sub-study of two prospective birth cohort studies.

Setting, participants: Participants in the Aboriginal Birth Cohort (ABC) — born to Indigenous mothers at the Royal Darwin Hospital during 1987–1990 — and the Top End Cohort (TEC) — people born to non-Indigenous mothers in Darwin, recruited during 2007–2009 — aged 32–35 years at the time of this sub-study.

Main outcome measures: Plasma aldosterone and direct renin concentrations; ARRs (positive screening test result for primary aldosteronism defined as > 70 pmol/mU); systolic and diastolic blood pressure.

Results: A total of 255 ABC (205 in remote, 50 in urban locations) and 76 TEC members participated. Median aldosterone concentration was similar for all three groups. The median renin concentration was 7.5 mU/L (interquartile range [IQR], 4.1–12.4 mU/L) in the TEC group, 12.4 mU/L (IQR, 5.1–19 mU/L) in the urban ABC group, and 29.3 mU/L (IQR, 15.0–52.9 mU/L) in the remote ABC group. The median ARR was 10 pmol/mU (IQR, 6–19 pmol/mU) in the remote ABC group, 28 pmol/mU (IQR, 16–70 pmol/mU) in the urban ABC group, and 43 pmol/mU (IQR, 26–74 pmol/mU) in the TEC group. Thirteen urban ABC participants (26%), 21 TEC participants (28%), and six people in the remote ABC group (3%) had ARR values above 70 pmol/mU. Adjusted for age and body mass index (BMI), mean systolic and diastolic blood pressure were lower for women than men in all participant groups; after adjusting for age, sex, and BMI, larger ARR was associated with higher systolic blood pressure in the TEC group but not the two ABC groups.

Conclusion: Screening test results for primary aldosteronism were positive for about one-quarter of urban Indigenous and non-Indigenous participants. A prospective study that includes confirmatory testing would more accurately assess the prevalence of primary aldosteronism among Indigenous Australians in the Northern Territory.

Original language	English
Pages (from-to)	263-269
Number of pages	7
Journal	Medical Journal of Australia
Volume	219
Issue number	6
Early online date	20 Jul 2023
DOIs	https://doi.org/10.5694/mja2.52062
Publication status	Published - 18 Sept 2023

Bibliographical note

Funding Information:
The aldosterone and renin test kits were provided by DiaSorin. The Aboriginal Birth Cohort study is funded by an National Health and Medical Research Council project grant (APP1138609). Jun Yang is supported by an NHMRC Investigator Grant. Morag J Young is supported by an Alice Baker and Eleanor Shaw Gender Equity Fellowship. Elisabeth Ng is supported by an NHMRC and Heart Foundation PhD Scholarship and a Royal Australasian College of Physicians Vincent Fairfax Family Foundation Research Entry Scholarship. The Hudson Institute of Medical Research and Baker Heart and Diabetes Institute are supported by the Operational Infrastructure Scheme of the Victorian government. Funders did not have any role in study design, data collection, analysis or interpretation, reporting or publication. We acknowledge Monash Pathology for determining plasma aldosterone and direct renin concentrations.

Funding Information:
The aldosterone and renin test kits were provided by DiaSorin. The Aboriginal Birth Cohort study is funded by an National Health and Medical Research Council project grant (APP1138609). Jun Yang is supported by an NHMRC Investigator Grant. Morag J Young is supported by an Alice Baker and Eleanor Shaw Gender Equity Fellowship. Elisabeth Ng is supported by an NHMRC and Heart Foundation PhD Scholarship and a Royal Australasian College of Physicians Vincent Fairfax Family Foundation Research Entry Scholarship. The Hudson Institute of Medical Research and Baker Heart and Diabetes Institute are supported by the Operational Infrastructure Scheme of the Victorian government. Funders did not have any role in study design, data collection, analysis or interpretation, reporting or publication. We acknowledge Monash Pathology for determining plasma aldosterone and direct renin concentrations.

Publisher Copyright:
© 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.

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Cite this

@article{ba2e2bb3c2be4ff29fd185e9c6ea95a6,

title = "Aldosterone and renin concentrations and blood pressure in young Indigenous and non-Indigenous adults in the Northern Territory: A cross-sectional study",

abstract = "Objectives: To evaluate aldosterone and renin levels and aldosterone-to-renin ratios (ARRs) in young Indigenous and non-Indigenous adults in the Northern Territory, and their association with blood pressure levels. Design: Cross-sectional study; single time point sub-study of two prospective birth cohort studies. Setting, participants: Participants in the Aboriginal Birth Cohort (ABC) — born to Indigenous mothers at the Royal Darwin Hospital during 1987–1990 — and the Top End Cohort (TEC) — people born to non-Indigenous mothers in Darwin, recruited during 2007–2009 — aged 32–35 years at the time of this sub-study. Main outcome measures: Plasma aldosterone and direct renin concentrations; ARRs (positive screening test result for primary aldosteronism defined as > 70 pmol/mU); systolic and diastolic blood pressure. Results: A total of 255 ABC (205 in remote, 50 in urban locations) and 76 TEC members participated. Median aldosterone concentration was similar for all three groups. The median renin concentration was 7.5 mU/L (interquartile range [IQR], 4.1–12.4 mU/L) in the TEC group, 12.4 mU/L (IQR, 5.1–19 mU/L) in the urban ABC group, and 29.3 mU/L (IQR, 15.0–52.9 mU/L) in the remote ABC group. The median ARR was 10 pmol/mU (IQR, 6–19 pmol/mU) in the remote ABC group, 28 pmol/mU (IQR, 16–70 pmol/mU) in the urban ABC group, and 43 pmol/mU (IQR, 26–74 pmol/mU) in the TEC group. Thirteen urban ABC participants (26\%), 21 TEC participants (28\%), and six people in the remote ABC group (3\%) had ARR values above 70 pmol/mU. Adjusted for age and body mass index (BMI), mean systolic and diastolic blood pressure were lower for women than men in all participant groups; after adjusting for age, sex, and BMI, larger ARR was associated with higher systolic blood pressure in the TEC group but not the two ABC groups. Conclusion: Screening test results for primary aldosteronism were positive for about one-quarter of urban Indigenous and non-Indigenous participants. A prospective study that includes confirmatory testing would more accurately assess the prevalence of primary aldosteronism among Indigenous Australians in the Northern Territory.",

keywords = "Adrenal gland diseases, Diagnostic tests and procedures, Endocrinology, Hypertension, Indigenous health, Preventive medicine, Public health, Rural health services",

author = "Elisabeth Ng and Gwini, \{Stella M.\} and Michael Stowasser and Young, \{Morag J.\} and Fuller, \{Peter J.\} and Singh, \{Gurmeet R.\} and Jun Yang",

note = "Funding Information: The aldosterone and renin test kits were provided by DiaSorin. The Aboriginal Birth Cohort study is funded by an National Health and Medical Research Council project grant (APP1138609). Jun Yang is supported by an NHMRC Investigator Grant. Morag J Young is supported by an Alice Baker and Eleanor Shaw Gender Equity Fellowship. Elisabeth Ng is supported by an NHMRC and Heart Foundation PhD Scholarship and a Royal Australasian College of Physicians Vincent Fairfax Family Foundation Research Entry Scholarship. The Hudson Institute of Medical Research and Baker Heart and Diabetes Institute are supported by the Operational Infrastructure Scheme of the Victorian government. Funders did not have any role in study design, data collection, analysis or interpretation, reporting or publication. We acknowledge Monash Pathology for determining plasma aldosterone and direct renin concentrations. Funding Information: The aldosterone and renin test kits were provided by DiaSorin. The Aboriginal Birth Cohort study is funded by an National Health and Medical Research Council project grant (APP1138609). Jun Yang is supported by an NHMRC Investigator Grant. Morag J Young is supported by an Alice Baker and Eleanor Shaw Gender Equity Fellowship. Elisabeth Ng is supported by an NHMRC and Heart Foundation PhD Scholarship and a Royal Australasian College of Physicians Vincent Fairfax Family Foundation Research Entry Scholarship. The Hudson Institute of Medical Research and Baker Heart and Diabetes Institute are supported by the Operational Infrastructure Scheme of the Victorian government. Funders did not have any role in study design, data collection, analysis or interpretation, reporting or publication. We acknowledge Monash Pathology for determining plasma aldosterone and direct renin concentrations. Publisher Copyright: {\textcopyright} 2023 The Authors. Medical Journal of Australia published by John Wiley \& Sons Australia, Ltd on behalf of AMPCo Pty Ltd.",

year = "2023",

month = sep,

day = "18",

doi = "10.5694/mja2.52062",

language = "English",

volume = "219",

pages = "263--269",

journal = "Medical Journal of Australia",

issn = "0025-729X",

publisher = "John Wiley \& Sons",

number = "6",

}

TY - JOUR

T1 - Aldosterone and renin concentrations and blood pressure in young Indigenous and non-Indigenous adults in the Northern Territory

T2 - A cross-sectional study

AU - Ng, Elisabeth

AU - Gwini, Stella M.

AU - Stowasser, Michael

AU - Young, Morag J.

AU - Fuller, Peter J.

AU - Singh, Gurmeet R.

AU - Yang, Jun

N1 - Funding Information: The aldosterone and renin test kits were provided by DiaSorin. The Aboriginal Birth Cohort study is funded by an National Health and Medical Research Council project grant (APP1138609). Jun Yang is supported by an NHMRC Investigator Grant. Morag J Young is supported by an Alice Baker and Eleanor Shaw Gender Equity Fellowship. Elisabeth Ng is supported by an NHMRC and Heart Foundation PhD Scholarship and a Royal Australasian College of Physicians Vincent Fairfax Family Foundation Research Entry Scholarship. The Hudson Institute of Medical Research and Baker Heart and Diabetes Institute are supported by the Operational Infrastructure Scheme of the Victorian government. Funders did not have any role in study design, data collection, analysis or interpretation, reporting or publication. We acknowledge Monash Pathology for determining plasma aldosterone and direct renin concentrations. Funding Information: The aldosterone and renin test kits were provided by DiaSorin. The Aboriginal Birth Cohort study is funded by an National Health and Medical Research Council project grant (APP1138609). Jun Yang is supported by an NHMRC Investigator Grant. Morag J Young is supported by an Alice Baker and Eleanor Shaw Gender Equity Fellowship. Elisabeth Ng is supported by an NHMRC and Heart Foundation PhD Scholarship and a Royal Australasian College of Physicians Vincent Fairfax Family Foundation Research Entry Scholarship. The Hudson Institute of Medical Research and Baker Heart and Diabetes Institute are supported by the Operational Infrastructure Scheme of the Victorian government. Funders did not have any role in study design, data collection, analysis or interpretation, reporting or publication. We acknowledge Monash Pathology for determining plasma aldosterone and direct renin concentrations. Publisher Copyright: © 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.

PY - 2023/9/18

Y1 - 2023/9/18

N2 - Objectives: To evaluate aldosterone and renin levels and aldosterone-to-renin ratios (ARRs) in young Indigenous and non-Indigenous adults in the Northern Territory, and their association with blood pressure levels. Design: Cross-sectional study; single time point sub-study of two prospective birth cohort studies. Setting, participants: Participants in the Aboriginal Birth Cohort (ABC) — born to Indigenous mothers at the Royal Darwin Hospital during 1987–1990 — and the Top End Cohort (TEC) — people born to non-Indigenous mothers in Darwin, recruited during 2007–2009 — aged 32–35 years at the time of this sub-study. Main outcome measures: Plasma aldosterone and direct renin concentrations; ARRs (positive screening test result for primary aldosteronism defined as > 70 pmol/mU); systolic and diastolic blood pressure. Results: A total of 255 ABC (205 in remote, 50 in urban locations) and 76 TEC members participated. Median aldosterone concentration was similar for all three groups. The median renin concentration was 7.5 mU/L (interquartile range [IQR], 4.1–12.4 mU/L) in the TEC group, 12.4 mU/L (IQR, 5.1–19 mU/L) in the urban ABC group, and 29.3 mU/L (IQR, 15.0–52.9 mU/L) in the remote ABC group. The median ARR was 10 pmol/mU (IQR, 6–19 pmol/mU) in the remote ABC group, 28 pmol/mU (IQR, 16–70 pmol/mU) in the urban ABC group, and 43 pmol/mU (IQR, 26–74 pmol/mU) in the TEC group. Thirteen urban ABC participants (26%), 21 TEC participants (28%), and six people in the remote ABC group (3%) had ARR values above 70 pmol/mU. Adjusted for age and body mass index (BMI), mean systolic and diastolic blood pressure were lower for women than men in all participant groups; after adjusting for age, sex, and BMI, larger ARR was associated with higher systolic blood pressure in the TEC group but not the two ABC groups. Conclusion: Screening test results for primary aldosteronism were positive for about one-quarter of urban Indigenous and non-Indigenous participants. A prospective study that includes confirmatory testing would more accurately assess the prevalence of primary aldosteronism among Indigenous Australians in the Northern Territory.

AB - Objectives: To evaluate aldosterone and renin levels and aldosterone-to-renin ratios (ARRs) in young Indigenous and non-Indigenous adults in the Northern Territory, and their association with blood pressure levels. Design: Cross-sectional study; single time point sub-study of two prospective birth cohort studies. Setting, participants: Participants in the Aboriginal Birth Cohort (ABC) — born to Indigenous mothers at the Royal Darwin Hospital during 1987–1990 — and the Top End Cohort (TEC) — people born to non-Indigenous mothers in Darwin, recruited during 2007–2009 — aged 32–35 years at the time of this sub-study. Main outcome measures: Plasma aldosterone and direct renin concentrations; ARRs (positive screening test result for primary aldosteronism defined as > 70 pmol/mU); systolic and diastolic blood pressure. Results: A total of 255 ABC (205 in remote, 50 in urban locations) and 76 TEC members participated. Median aldosterone concentration was similar for all three groups. The median renin concentration was 7.5 mU/L (interquartile range [IQR], 4.1–12.4 mU/L) in the TEC group, 12.4 mU/L (IQR, 5.1–19 mU/L) in the urban ABC group, and 29.3 mU/L (IQR, 15.0–52.9 mU/L) in the remote ABC group. The median ARR was 10 pmol/mU (IQR, 6–19 pmol/mU) in the remote ABC group, 28 pmol/mU (IQR, 16–70 pmol/mU) in the urban ABC group, and 43 pmol/mU (IQR, 26–74 pmol/mU) in the TEC group. Thirteen urban ABC participants (26%), 21 TEC participants (28%), and six people in the remote ABC group (3%) had ARR values above 70 pmol/mU. Adjusted for age and body mass index (BMI), mean systolic and diastolic blood pressure were lower for women than men in all participant groups; after adjusting for age, sex, and BMI, larger ARR was associated with higher systolic blood pressure in the TEC group but not the two ABC groups. Conclusion: Screening test results for primary aldosteronism were positive for about one-quarter of urban Indigenous and non-Indigenous participants. A prospective study that includes confirmatory testing would more accurately assess the prevalence of primary aldosteronism among Indigenous Australians in the Northern Territory.

KW - Adrenal gland diseases

KW - Diagnostic tests and procedures

KW - Endocrinology

KW - Hypertension

KW - Indigenous health

KW - Preventive medicine

KW - Public health

KW - Rural health services

UR - https://www.scopus.com/pages/publications/85167657067

U2 - 10.5694/mja2.52062

DO - 10.5694/mja2.52062

M3 - Article

AN - SCOPUS:85167657067

SN - 0025-729X

VL - 219

SP - 263

EP - 269

JO - Medical Journal of Australia

JF - Medical Journal of Australia

IS - 6

ER -

Aldosterone and renin concentrations and blood pressure in young Indigenous and non-Indigenous adults in the Northern Territory: A cross-sectional study

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