Association Between Blood Pressure and Branched-Chain/Aromatic Amino Acid Excretion Rate in 24-Hour Urine Samples from Elderly Hypertension Patients

Figures & data

Table 1 Demographic Characteristics of the Study Subjects According to Quartiles of Total BCAAs

Characteristics	Q1 (81)	Q2 (80)	Q3 (82)	Q4 (79)	P-value
Age (year)*	70(67, 76)	68(65, 75)	68(65, 72)	67(64, 71)	0.001
Height (cm)	157.3 ± 8.5	158.5 ± 8.1	160.0 ± 7.7	162.7 ± 8.8	<0.001
Weight (kg)	62.85 ± 10.3	63.4 ± 11.5	65.6 ± 10.4	70.0 ± 11.4	<0.001
Urine volume (mL)*	800(625, 1050)	950(662, 1400)	1194(800, 1620)	1400(1000, 1900)	<0.001
Gender (female)	46 (56.8%)	50 (62.5%)	34 (41.5%)	30 (38.0%)	0.004
Smoking history	16 (19.8%)	17 (21.3%)	24 (29.3%)	22 (27.8%)	0.403
Current smoking habit	7 (8.6%)	8 (10.0%)	13 (15.9%)	11 (13.9%)	0.462
Education (primary)	79 (97.5%)	78 (97.5%)	75 (91.5%)	72 (91.1%)	0.101
Drugs History
Diuretics	14 (17.3%)	12 (15.0%)	14 (17.1%)	9 (11.4%)	0.709
ACEI	26 (32.1%)	29 (36.3%)	30 (36.6%)	31 (39.2%)	0.823
α-receptor blockers	5 (6.2%)	2 (2.5%)	3 (3.7%)	4 (5.1%)	0.673
β-receptor blockers	7 (8.6%)	9 (11.3%)	10 (12.2%)	13 (16.5%)	0.499
Calcium antagonists	42 (51.9%)	45 (56.3%)	50 (61.0%)	52 (65.8%)	0.309
Other antihypertensives	16 (19.8%)	11 (13.8%)	11 (13.4%)	9 (11.4%)	0.472
Lipid-lowering drugs	7 (8.6%)	3 (3.8%)	4 (4.9%)	3 (3.8%)	0.461
Antiplatelet agents	24 (29.6%)	20 (25.0%)	22 (26.8%)	18 (22.8%)	0.790

Note: * Values shown are Median (P25, P75).

Abbreviations: ACEI, angiotensin conversion enzyme inhibitors; total BCAAs, valine + isoleucine + leucine; Q₁, first quartile; Q₂, second quartile; Q₃, third quartile; Q₄, fourth quartile.

Table 2 Demographic Characteristics of the Study Subjects According to Quartiles of Total AAAs

Characteristics	Q1 (80)	Q2 (81)	Q3 (81)	Q4 (80)	P-value
Age (year)*	70(66, 76)	69(66, 74)	67(64, 73)	67(64, 71)	0.013
Height (cm)	157.3 ± 8.0	157.5 ± 7.7	160.4 ± 7.9	163.2 ± 9.0	<0.001
Weight (kg)	62.6 ± 10.5	62.8 ± 10.4	64.8 ± 11.0	70.4 ± 11.6	<0.001
Urine volume*	925(700, 1200)	900(700, 1500)	1150(690, 1550)	1355(1000, 1750)	<0.001
Gender (female)	51 (63.8%)	45 (55.6%)	37 (45.7%)	27 (33.8%)	0.001
Smoking history	15 (18.8%)	17 (21.0%)	26 (32.1%)	21 (26.3%)	0.201
Current smoking habit	6 (7.5%)	9 (11.1%)	12 (14.8%)	12 (15.0%)	0.414
Education (primary)	78 (97.5%)	79 (97.5%)	76 (93.8%)	71 (88.8%)	0.057
Drugs history
Diuretics	19 (23.8%)	10 (12.3%)	9 (11.1%)	11 (13.8%)	0.101
ACEI	25 (31.3%)	30 (37.0%)	29 (35.8%)	32 (40.0%)	0.711
α-receptor blockers	5 (6.3%)	3 (3.7%)	2 (2.5%)	4 (5.0%)	0.662
β-receptor blockers	9 (11.3%)	6 (7.4%)	15 (18.5%)	9 (11.3%)	0.178
Calcium antagonists	41 (51.3%)	50 (61.7%)	47 (58.0%)	51 (63.8%)	0.392
Other antihypertensives	17 (21.3%)	11 (13.6%)	11 (13.6%)	8 (10.0%)	0.228
Lipid-lowering drugs	6 (7.5%)	4 (4.9%)	3 (3.7%)	4 (5.0%)	0.758
Antiplatelet agents	23 (38.8%)	23 (28.4%)	14 (17.3%)	24 (30.0%)	0.221

Note: *Values shown are Median (P25, P75).

Abbreviations: ACEI, angiotensin conversion enzyme inhibitors; total AAAs, tyrosine + phenylalanine + tryptophan; Q₁, first quartile; Q₂, second quartile; Q₃, third quartile; Q₄, fourth quartile.

Table 3 Average SBP and DBP in Quartiles of BCAAs and AAAs in 24-Hour Urine Samples

		SBP	DBP
Val	Q1	162.8 ± 22.7	93.0 ± 14.7
	Q2	162.8 ± 20.2	93.3 ± 13.4
	Q3	163.1 ± 20.1	93.5 ± 13.7
	Q4	161.7 ± 21.7	92.2 ± 15.0
	P-value	0.975	0.944
Ile	Q1	163.8 ± 23.2	91.4 ± 13.4
	Q2	163.0 ± 21.7	94.8 ± 14.9
	Q3	161.6 ± 18.6	93.2 ± 14.5
	Q4	162.0 ± 20.8	92.6 ± 13.7
	P-value	0.908	0.487
Leu	Q1	163.0 ± 24.8	92.7 ± 14.0
	Q2	160.3 ± 16.5	91.8 ± 13.2
	Q3	163.8 ± 21.2	93.2 ± 14.5
	Q4	163.3 ± 21.3	94.4 ± 15.0
	P-value	0.721	0.715
Tyr	Q1	161.5 ± 23.6	91.3 ± 13.6
	Q2	163.6 ± 18.1	94.6 ± 13.0
	Q3	163.6 ± 21.1	92.9 ± 15.3
	Q4	161.7 ± 21.7	93.2 ± 14.7
	P-value	0.876	0.526
Trp	Q1	162.5 ± 23.4	91.5 ± 14.1
	Q2	163.0 ± 18.8	93.9 ± 13.3
	Q3	160.1 ± 19.5	91.6 ± 13.3
	Q4	164.9 ± 22.5	95.0 ± 15.6
	P-value	0.547	0.292
Phe	Q1	162.7 ± 20.3	93.8 ± 13.0
	Q2	165.2 ± 25.2	94.6 ± 15.8
	Q3	163.2 ± 19.3	91.5 ± 14.1
	Q4	159.4 ± 18.6	92.2 ± 13.6
	P-value	0.381	0.482

Abbreviations: Val, valine; Ile, isoleucine; Leu, leucine; Tyr, tyrosine; Phe, phenylalanine; Trp, tryptophan; Q₁, first quartile; Q₂, second quartile; Q₃, third quartile; Q₄, fourth quartile.

Table 4 Multivariable-Adjusted β and 95% CI Value of Amino Acids and BP

	Model 1		Model 2		Model 3
	Variables	β (95% CI)	Variables	β (95% CI)	Variables	β (95% CI)
SBP	Val	−0.232(−0.116,-0.006)	Val	−0.325 (−0.147, −0.024)	Val	−0.301 (−0.140, −0.017)
DBP	Val	−0.144(−0.089,-0.005)	Val	−0.194 (−0.113, −0.015)	Val	−0.328 (−0.171, −0.044)
					Ile	0.170 (0.001, 0.066)

Notes: Model 1: adjusted for age, gender, height, weight; Model 2: Model 1 + urine volume; Model 3: Model 2 + drugs history; BP and amino acids were converted by log.

Abbreviations: β, the standardized partial regression coefficient; 95% CI, 95% confidence interval; Collinearity testing was used to avoid inclusion of interdependent model variables.

Figure 1 Mean (95% CI) SBP (A, P-trend = 0.784) and DBP (B, P-trend = 0.734; C, P-trend = 0.723) by quartiles of BCAAs on the basis of quartiles.

Notes: Figure 1 describes the differences in BP by quartiles of BCAAs on the basis of quartiles. Quartile cutoffs were as follows: Val: 0.0890 (25^th percentile), 0.2317 (50^th percentile), and 0.3927 (75^th percentile); Ile, -0.8861, -0.6778 and -0.4949. BPs and BCAAs excretion rate are presented log values. The abscissa represents the quartiles of BCAAs, and ordinate represents logSBP (95%CI) or logDBP (95%CI).
Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; BCAAs, valine + leucine + isoleucine.