Differences in target organ damage between captopril challenge test-defined definitive-positive and borderline-range groups among patients with primary aldosteronism.

Autor: Fujiwara N; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Haze T; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan. haze.tat.bg@yokohama-cu.ac.jp.; YCU Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University Hospital, Yokohama, Japan. haze.tat.bg@yokohama-cu.ac.jp.; Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama, Japan. haze.tat.bg@yokohama-cu.ac.jp., Wakui H; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Tamura K; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.; Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama, Japan., Tsuiki M; Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan., Kamemura K; Department of Cardiology, Shinko Hospital, Kobe, Japan., Taura D; Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan., Ichijo T; Department of Diabetes and Endocrinology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan., Takahashi Y; Department of Diabetes and Endocrinology, Nara Medical University, Nara, Japan., Watanabe M; Department of Endocrinology and Diabetes, Okazaki City Hospital, Okazaki, Japan., Kobayashi H; Division of Nephrology, Hypertension, and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan., Nakamura T; Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan., Izawa S; Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Japan., Wada N; Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan., Yamada T; Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Yokota K; Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan., Naruse M; Endocrine Center, Ijinkai Takeda General Hospital, Kyoto, Japan., Sone M; Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Jazyk: angličtina
Zdroj: Hypertension research : official journal of the Japanese Society of Hypertension [Hypertens Res] 2024 Oct 15. Date of Electronic Publication: 2024 Oct 15.
DOI: 10.1038/s41440-024-01943-w
Abstrakt: The new Japanese guidelines for primary aldosteronism introduce a category in the judgment of functional confirmatory tests that is called the "borderline range," which is rare in the other international guidelines. The clinical characteristics of this borderline group are not yet understood. To investigate whether this borderline group has any significant differences in terms of target organ damage, we used data from a Japanese nationwide registry (JPAS-II) of individuals with primary aldosteronism or essential hypertension to compare the borderline group with the definitive-positive group and the negative group. We analyzed the cases of 1785 patients based on their captopril-challenge test results. Since the JPAS-II database contains plasma aldosterone concentration values obtained based on both radioimmunoassay (n = 1555) and chemiluminescent enzyme immunoassay (n = 230) principles, we converted these values to their equivalents as if measured by chemiluminescent enzyme immunoassay and conducted all analyses under the simulated condition. Multicovariate-adjusted models revealed significant prevalance odds ratios for chronic kidney disease (2.01, 95% confidence interval: 1.13 to 3.61), electrocardiographic abnormalities (1.66, 95% confidence interval: 1.16 to 2.37). No significant difference was observed between the borderline and negative groups in these assessments (odds ratio [95% confidence interval] for chronic kidney disease: 0.73 [0.26 to 2.02] and electrocardiographic abnormalities: 1.01 [0.60 to 1.70]). We confirmed that the prevalence of target organ damage increases linearly as the aldosterone-to-renin ratio rises following the captopril challenge test. These results provide material to consider regarding the significance of the provisionally established borderline group.
Competing Interests: Compliance with ethical standards Conflict of interest The authors declare no competing interests.
(© 2024. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)
Databáze: MEDLINE
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