Left ventricular hypertrophy (LVH) poses a great risk of cardiovascular morbidity and mortality in adults and may pose a serious risk in children. Adult studies have shown that renin–angiotensin–aldosterone system (RAAS) levels directly correlate with left ventricular mass index (LVMI). The purpose of this study is to explore race- and sex-related effects of the RAAS on LVMI in adolescents.

Data were collected from a sample of 89 blacks (44 girls, 45 boys) and 102 whites (40 girls, 62 boys) aged 15–19. Data collected included sex, age, body mass index (BMI), LVMI, baseline blood pressure, and levels of aldosterone and angiotensin II.

In black males, increased aldosterone levels correlated with decreased sodium excretion (r = −0.336, p = 0.024), increased blood pressure (r = 0.358, p = 0.016), and increased LVMI (r = 0.342, p = 0.022). In black females, increased aldosterone levels correlated with increased baseline blood pressure (r = 0.356, p = 0.018). In white males, increased aldosterone correlated with decreased sodium excretion (r = −0.391, p = 0.002). In white females, aldosterone levels correlated with increased baseline blood pressure (r = 0.323, p = 0.042) and decreased sodium excretion (r = −0.342, p = 0.031).

The results suggest the following model in black males: increased aldosterone leads to increased sodium retention, causing a volume-mediated increase in blood pressure; increased blood pressure results in increased left ventricular mass, and eventually LVH.