Cardiac remodeling patterns in hypertension depending on age, gender, and renin blood test

Aim: to determine the association between the frequency and severity of cardiac remodeling and renin blood test in patients of different ages and sexes suffering from hypertension. Materials and Methods: the study included 120 patients: 60 men and 60 women. These patients were divided into three age groups, 40 individuals each (20 men and 20 women per group): young adults (25–44 years), middle-aged adults (45–59 years), and elderly patients (60 years and older). At the time of examination, none of the patients were taking medications that could affect serum renin or aldosterone concentrations. All participants underwent measurement of venous blood renin and aldosterone levels using enzyme-linked immunosorbent assay (ELISA). Echocardiography was performed to determine the type of cardiac remodeling by assessing relative wall thickness (RWT) of the left ventricle (LV) and left ventricular mass index (LVMI). The geometric pattern of the LV was also evaluated. Results and Discussion: the following patterns were identified — in the young age group, normal LV geometry with normoreninemic hypertension predominated (98%). In the middle-aged group, concentric LV remodeling (30%) was accompanied by hyperreninemic hypertension, while normal LV geometry was mainly associated with normoreninemic hypertension (48%). In 50% of elderly patients, elevated renin levels and predominance of concentric LV remodeling were detected. Aldosterone concentrations did not depend on age or sex among patients with hypertension. Spearman correlation analysis demonstrated a positive association between blood renin levels and both RWT and LVMI in middle-aged patients (ρ=0.621 and ρ=0.355, respectively) and elderly patients (ρ=0.366 and ρ=0.427, respectively). In postmenopausal women, a significant increase in renin blood test was observed, independent of duration of postmenopause. Conclusions: this study revealed the following patterns of cardiac remodeling in hypertension, depending on age, sex, and renin blood test — in patients with hypertension, advancing age was associated with a significant increase in LV mass and blood renin concentration. In both middle-aged and elderly patients, LVMI and blood renin levels were significantly higher in men compared to women. The concentric type of LV remodeling developed much more frequently in patients with the hyperreninemic hypertension. Keywords: cardiac remodeling, renin, aldosterone, arterial hypertension, sex, age, echocardiography, renin-angiotensin-aldosterone system (RAAS). For citation: Pavlova V.A., Pavlova A.A., Weber V.R., Zhmailova S.V. Cardiac remodeling patterns in hypertension depending on age, gender, and renin blood test. RMJ. 2025;6:6–9. DOI: 10.32364/2225-2282-2025-6-2