Elevated plasma aldosterone-to-renin ratio as a potential risk marker of adverse left ventricular remodeling: a cross-sectional study

Background Recent evidence has suggested that primary aldosteronism (PA) is the predominant cause of secondary hypertension and is linked to adverse left ventricular (LV) remodeling. However, few studies have investigated the potential associations of aldosterone-to-renin ratio (ARR), an important parameter for PA screening, with the risk of adverse LV remodeling in the Chinese population. This study aimed to investigate the associations of ARR, plasma aldosterone concentration (PAC), and plasma renin concentration (PRC) with adverse LV remodeling in a population from Guangxi, China. Methods The analyzed data were primarily obtained from the First Affiliated Hospital of Guangxi Medical University and the First People’s Hospital of Yulin City during the period from September 2022 to March 2024. A total of 724 participants (mean age: 56.4 ± 14.3 years, 71% with hypertension) who underwent aldosterone–renin testing and echocardiography were included in the study. Data on demographics, clinical history, and medications, including calcium channel blockers and mineralocorticoid receptor antagonists (MRAs), were collected. We applied a generalized linear model (GLM) and a multivariable logistic regression model to estimate the relationships between ARR, PAC, and PRC with the risk of adverse LV remodeling and left ventricular hypertrophy (LVH) and further explored the dose–response relationship. Results Of the 724 participants included in this study, GLM revealed that ARR was associated with greater left atrium size, left ventricular end-diastolic diameter, left ventricular mass, and left ventricular mass index. In adjusted multivariable regression analyses, one standard deviation (SD) of ARR emerged as a significant predictor of LVH occurrence [OR = 1.531 (95%CI, 1.041–2.251), p = 0.030], and compared with the first tertile of ARR, the third tertile of ARR had a 2.106-fold higher risk of LVH ( p -trend