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Arterial stiffness, intima-media thickness and carotid artery fibrosis in patients with primary aldosteronism
Abstract
OBJECTIVES: To evaluate vascular wall structure and conduit artery stiffness in patients with primary aldosteronism. METHODS: This observational study, conducted in a University Hypertension Center, evaluated the carotid wall by 2-D ultrasonography and ultrasonic tissue characterization, and analyzed arterial stiffness by applanation tonometer. Twenty-three consecutive patients with primary aldosteronism, 24 matched patients with essential hypertension and 15 controls were studied. Intima-media thickness and corrected integrated backscatter signal of the carotid arteries were evaluated. Radial and femoral pulse wave velocity and aortic augmentation index were also investigated. RESULTS: Intima-media thickness in patients with essential hypertension (0.69 +/- 0.03 mm) was higher (P < 0.04) than that in controls (0.59 +/- 0.02 mm). This finding was more evident in primary aldosteronism patients (0.84 +/- 0.03 mm), in whom intima-media thickness was greater than that in controls (P < 0.0001) or in patients with essential hypertension (P < 0.01). Similarly, corrected integrated backscatter signal in patients with essential hypertension (-23.6 +/- 0.35 dB) was higher (P < 0.0001) than that in controls (-26.2 +/- 0.44 dB), but it was even more elevated in patients with primary aldosteronism (-22.1 +/- 0.46 dB), who showed greater corrected integrated backscatter signal than was the case in patients with essential hypertension (P < 0.009) or in controls (P < 0.0001). Femoral pulse wave velocity was higher in primary aldosteronism patients (10.8 +/- 0.57 m/s) than in patients with essential hypertension (9.1 +/- 0.34 m/s, P < 0.03) or in controls (7.1 +/- 0.51 m/s, P < 0.0001). Femoral pulse wave velocity was lower in controls than in patients with essential hypertension (P < 0.0001). The same pattern was observed for radial pulse wave velocity. Aortic augmentation index was higher in primary aldosteronism patients (28.2 +/- 2.1%) than in patients with essential hypertension (26.0 +/- 1.8%) or in controls (16.8 +/- 2.0%, P < 0.001). Patients with essential hypertension likewise exhibited higher aortic augmentation index than controls (P < 0.001). CONCLUSION: Aldosterone excess is responsible per se for vascular morphological (wall thickening and carotid artery fibrosis) and functional (central stiffness) damage.
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“Primary aldosteronism is also associated with left ventricular hypertrophy, diastolic dysfunction and heart failure, large artery stiffness, oxidative stress, widespread tissue inflammation and fibrosis, and increased resistance vessel remodeling compared with primary hypertension.291–293”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [292]
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Metadata
- Authors
- Bernini, G., Galetta, F., Franzoni, F., Bardini, M., Taurino, C., Bernardini, M., Ghiadoni, L., Bernini, M., Santoro, G., & Salvetti, A.
- Affiliations
- University of Pisa (IT)
- Corresponding author
- Bernini, Giampaolo
- Bernini, Matteo
- Venue
- Journal of Hypertension
- Published
- 2008-12
- Volume
- 26
- Issue
- 12
- Pages
- 2399-2405
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W1985050616
- Cited by
- 136
- References
- 40
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 8 · 2023: 4 · 2022: 15 · 2021: 5 · 2020: 11 · 2019: 9 · 2018: 16 · 2017: 9 · 2016: 11 · 2015: 6 · 2014: 4 · 2013: 9 · 2012: 9
- FWCI
- 3.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Nephrology › Renal and Vascular Pathologies
- Keywords
- primary aldosteronism, arterial stiffness, intima-media thickness, carotid intima-media thickness, integrated backscatter, pulse wave velocity, aortic augmentation index, essential hypertension, vascular wall structure, applanation tonometry, carotid ultrasound, tissue characterization, cardiovascular risk stratification, renin-angiotensin system
- MeSH terms
- Aorta, Carotid Arteries, Elasticity, Female, Femoral Artery, Fibrosis, Humans, Hyperaldosteronism, Hypertension, Male, Middle Aged, Pulsatile Flow, Regional Blood Flow, Ultrasonography, Case-Control Studies, Radial Artery, Tunica Intima, Tunica Media
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