Nadir Aldosterone Levels After Confirmatory Tests Are Correlated With Left Ventricular Hypertrophy in Primary Aldosteronism

Autor: Yoshihiro Ogawa, Ryuji Okamoto, Jpas, Hiroki Kobayashi, Takanobu Yoshimoto, Junji Kawashima, Kouichi Tamura, Hiroshi Itoh, Shoichiro Izawa, Norio Wada, Kohei Kamemura, Yuichi Matsuda, Shintaro Okamura, Koichi Yamamoto, Takashi Yoneda, Masakatsu Sone, Ryuichi Sakamoto, Nobuya Inagaki, Mika Tsuiki, Akiyuki Kawashima, Isao Kurihara, Tetsuya Yamada, Yoshiyu Takeda, Michio Otsuki, Youichi Ohno, Takuyuki Katabami, Akiyo Tanabe, Takamasa Ichijo, Mitsuhide Naruse
Rok vydání: 2020
Předmět:
Zdroj: Hypertension. 75:1475-1482
ISSN: 1524-4563
0194-911X
DOI: 10.1161/hypertensionaha.119.14601
Popis: Left ventricular hypertrophy (LVH) is often seen in patients with primary aldosteronism (PA), and the prevalence of LVH is reportedly higher among patients with PA than patients with essential hypertension. However, the correlation between aldosterone levels and LVH is undefined, and how aldosterone affects LVH in patients with PA remains unclear. We, therefore, retrospectively assessed a large PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) to reveal the factors associated with LVH in patients with PA without suspected autonomous cortisol secretion. In the 1186 patients with PA studied, the basal plasma aldosterone concentration, plasma renin activity, and the aldosterone-to-renin ratio did not significantly correlate with left ventricular LV mass index (LVMI) in single or multiple regression analyses. However, the plasma aldosterone concentration after the captopril challenge test or saline-infusion test, which are associated with autonomous aldosterone secretion, correlated significantly with LVMI, even after adjusting for patients’ backgrounds, including age and blood pressure. In addition, hypokalemia and the unilateral subtype also correlated with LVMI. Longitudinal subanalysis of medically or surgically treated patients with PA showed significant reductions in LVMI in both the surgery (63.0±18.1 to 55.3±19.5 g/m 2.7 , P 2.7 , P
Databáze: OpenAIRE