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Cited by 505Hormonal Regulation and HypertensionRenin-Angiotensin System StudiesPotassium and Related Disorders

Cardiovascular Complications Associated With Primary Aldosteronism: A Controlled Cross-Sectional Study

Savard, Sébastien, Amar, Laurence, Plouin, Pierre-François, Steichen, Olivier·2013·Hypertension
DOI 10.1161/hypertensionaha.113.01060
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Abstract

A higher risk of cardiovascular events has been reported in patients with primary aldosteronism (PA) than in otherwise similar patients with essential hypertension (EH). However, the evidence is limited by small sample size and potential confounding factors. We, therefore, compared the prevalence of cardiovascular events in 459 patients with PA diagnosed in our hypertension unit from 2001 to 2006 and 1290 controls with EH. PA cases and EH controls were individually matched for sex, age (±2 years), and office systolic blood pressure (±10 mm Hg). Patients with PA and EH differed significantly in duration of hypertension, serum potassium, plasma aldosterone and plasma renin concentrations, aldosterone-to-renin ratio, and urinary aldosterone concentration (P<0.001 for all comparisons). The prevalence of electrocardiographic and echocardiographic left ventricular hypertrophy was about twice higher in patients with PA even after adjustment for hypertension duration. PA patients also had a significantly higher prevalence of coronary artery disease (adjusted odds ratio, 1.9), nonfatal myocardial infarction (adjusted odds ratio, 2.6), heart failure (adjusted odds ratio, 2.9), and atrial fibrillation (adjusted odds ratio, 5.0). The risks associated with PA were similar across levels of serum potassium and plasma aldosterone. To conclude, patients with PA are more likely to have had a cardiovascular complication at diagnosis than otherwise similar patients with EH. Target organ damage and complications disproportionate to blood pressure should be considered as an additional argument for suspecting PA in a given individual and possibly for broadening the scope of screening at the population level.

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  • Primary aldosteronism is 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.

    “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 [291]

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Authors
Savard, S., Amar, L., Plouin, P.-F., & Steichen, O.
Affiliations
Assistance Publique – Hôpitaux de Paris (FR)
ORCID
Venue
Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2013-08
Volume
62
Issue
2
Pages
331-336
ISSN
  • 0194-911X (ISSN-L)
  • 1524-4563
DOI
10.1161/hypertensionaha.113.01060
OpenAlex
W2168924012
Cited by
505
References
50
Citations by year
2026: 24 · 2025: 34 · 2024: 37 · 2023: 39 · 2022: 48 · 2021: 46 · 2020: 41 · 2019: 43 · 2018: 38 · 2017: 47 · 2016: 32 · 2015: 37 · 2014: 29 · 2013: 10
FWCI
28.37
Type
journal article
Language
en
Open access
closed
Locations
  • Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
Keywords
primary aldosteronism, cardiovascular complications, essential hypertension, left ventricular hypertrophy, coronary artery disease, myocardial infarction, heart failure, atrial fibrillation, aldosterone-renin ratio, serum potassium, plasma aldosterone, target organ damage
MeSH terms
Adult, Cardiovascular Diseases, Cross-Sectional Studies, Female, Humans, Hyperaldosteronism, Hypertension, Male, Middle Aged, Hypertrophy, Left Ventricular

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