Aldosteronism is associated with more severe cerebral small vessel disease in hypertensive intracerebral hemorrhage.

Autor: Lee BC; Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan, ROC.; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, ROC.; Department of Medical Imaging, National Taiwan University Hospital Yun-lin Branch, Douliu, Taiwan, ROC., Tsai HH; Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan, ROC., Chen ZW; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, ROC.; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC.; Department of Internal Medicine, National Taiwan University Hospital Yun-lin Branch, Douliu, Taiwan, ROC., Chang CC; Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan, ROC., Huang JZ; Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan, ROC., Chang YY; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, ROC.; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC.; Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC., Tsai CH; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, ROC.; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC., Chou CH; Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan, ROC., Liao CW; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, HsinChu, Taiwan, ROC.; National Taiwan University Cancer Center, Taipei, Taiwan, ROC., Pan CT; Department of Internal Medicine, National Taiwan University Hospital Yun-lin Branch, Douliu, Taiwan, ROC., Wu VC; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC., Hung CS; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC.; Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan, ROC., Tsai LK; Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan, ROC. milikai@ntuh.gov.tw., Lin YH; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC. austinr34@gmail.com.; Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan, ROC. austinr34@gmail.com.
Jazyk: angličtina
Zdroj: Hypertension research : official journal of the Japanese Society of Hypertension [Hypertens Res] 2024 Mar; Vol. 47 (3), pp. 608-617. Date of Electronic Publication: 2023 Nov 22.
DOI: 10.1038/s41440-023-01458-w
Abstrakt: Primary aldosteronism is associated with various types of cardiovascular and cerebrovascular damage independently of hypertension. Although chronic hypertension and related cerebral arteriosclerosis are the main risk factors for intracerebral hemorrhage, the effects of aldosteronism remain poorly understood. We enrolled 90 survivors of hypertensive intracerebral hemorrhage, 21 of them with aldosteronism and 69 with essential hypertension as controls in this study. Clinical parameters and neuroimaging markers of cerebral small vessel disease were recorded, and its correlations with aldosteronism were investigated. Our results showed that the aldosteronism group (55.2 ± 9.7 years, male 47.6%) had similar hypertension severity but exhibited a higher cerebral microbleed count (interquartile range) (8.5 [2.0‒25.8] vs 3 [1.0‒6.0], P = 0.005) and higher severity of dilated perivascular space in the basal ganglia (severe perivascular space [number >20], 52.4% vs. 24.6%, P = 0.029; large perivascular space [>3 mm], 52.4% vs. 20.3%, P = 0.010), compared to those with essential hypertension (53.8 ± 11.7 years, male 73.9%). In multivariate models, aldosteronism remained an independent predictor of a higher (>10) microbleed count (odds ratio = 8.60, P = 0.004), severe perivascular space (odds ratio = 4.00, P = 0.038); the aldosterone-to-renin ratio was associated with dilated perivascular space (P = 0.043) and large perivascular space (P = 0.008). In conclusions, survivors of intracerebral hemorrhage with aldosteronism showed a tendency towards more severe hypertensive arteriopathy than the essential hypertension counterparts independently of blood pressure; aldosteronism may contribute to dilated perivascular space around the deep perforating arteries. Aldosteronism is associated with more severe cerebral small vessel disease in hypertensive intracerebral hemorrhage.
(© 2023. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)
Databáze: MEDLINE
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