Aldosterone-to-renin ratio and nocturnal blood pressure decline assessed by self-measurement of blood pressure at home: The Ohasama Study

Michihiro Satoh, Miki Hosaka, Kei Asayama, Masahiro Kikuya, Ryusuke Inoue, Hirohito Metoki, Megumi T. Utsugi, Azusa Hara, Takuo Hirose, Taku Obara, Takefumi Mori, Kazuhito Totsune, Haruhisa Hoshi, Nariyasu Mano, Yutaka Imai, Takayoshi Ohkubo

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13 Citations (Scopus)


Based on ambulatory blood pressure (BP) monitoring, the aldosterone-to-renin ratio (ARR) has been reported to be associated with a diminished nocturnal decline in BP, generally referred to as a "non-dipping" pattern. The objective of this cross-sectional study was to investigate the association between ARR and the non-dipping pattern based on home BP measurements. This study included 177 participants 55 years from the general population of Ohasama (mean age: 67.2 years; 74.6% women); no patient was receiving antihypertensive treatment. The median plasma renin activity (PRA), plasma aldosterone concentration (PAC) and ARR were 0.8ng/mL/h, 8.1ng/dL and 9.7ng/dL per ng/mL/h, respectively. Each 1 SD increase in log-transformed (ln) ARR was significantly associated with the prevalence of the non-dipping pattern after adjustments for possible confounding factors including home morning systolic BP (odds ratio, 1.45; p=0.049). However, no significant associations of PRA or PAC with the non-dipping pattern were observed (p0.2). When participants were divided into four groups according to median levels of home morning and night-time systolic BPs, the group with a higher home morning systolic BP (128.4mmHg) with a higher home night-time systolic BP (114.4mmHg) had the greatest ARR levels (ANCOVA p=0.01). These results support the hypothesis that relative aldosterone excess may be related to a non-dipping pattern in a general population and suggest that a non-dipping pattern can be accurately observed by home BP measurements.

Original languageEnglish
Pages (from-to)108-114
Number of pages7
JournalClinical and Experimental Hypertension
Issue number2
Publication statusPublished - 2014


  • Aldosterone
  • Home blood pressure
  • Nocturnal decline in blood pressure
  • Non-dipping
  • Renin

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology


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