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

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... Full description

Journal Title: Hypertension (Dallas Tex. 1979), 2013-08, Vol.62 (2), p.331-336
Main Author: Savard, Sébastien
Other Authors: Amar, Laurence , Plouin, Pierre-François , Steichen, Olivier
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Hagerstown, MD: American Heart Association, Inc
ID: ISSN: 0194-911X
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recordid: cdi_proquest_miscellaneous_1406176887
title: Cardiovascular Complications Associated With Primary Aldosteronism: A Controlled Cross-Sectional Study
format: Article
creator:
  • Savard, Sébastien
  • Amar, Laurence
  • Plouin, Pierre-François
  • Steichen, Olivier
subjects:
  • Adrenals. Adrenal axis. Renin-angiotensin system (diseases)
  • Adult
  • Arterial hypertension. Arterial hypotension
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Cardiac dysrhythmias
  • Cardiology. Vascular system
  • Cardiovascular Diseases - etiology
  • Coronary heart disease
  • Cross-Sectional Studies
  • Endocrinopathies
  • Female
  • Heart
  • Humans
  • Hyperaldosteronism - complications
  • Hypertension - complications
  • Hypertrophy, Left Ventricular - etiology
  • Male
  • Medical sciences
  • Middle Aged
  • Non tumoral diseases. Target tissue resistance. Benign neoplasms
ispartof: Hypertension (Dallas, Tex. 1979), 2013-08, Vol.62 (2), p.331-336
description: 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
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleCardiovascular Complications Associated With Primary Aldosteronism: A Controlled Cross-Sectional Study
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descriptionA 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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subjectAdrenals. Adrenal axis. Renin-angiotensin system (diseases) ; Adult ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Cardiovascular Diseases - etiology ; Coronary heart disease ; Cross-Sectional Studies ; Endocrinopathies ; Female ; Heart ; Humans ; Hyperaldosteronism - complications ; Hypertension - complications ; Hypertrophy, Left Ventricular - etiology ; Male ; Medical sciences ; Middle Aged ; Non tumoral diseases. Target tissue resistance. Benign neoplasms
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descriptionA 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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2Arterial hypertension. Arterial hypotension
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4Blood and lymphatic vessels
5Cardiac dysrhythmias
6Cardiology. Vascular system
7Cardiovascular Diseases - etiology
8Coronary heart disease
9Cross-Sectional Studies
10Endocrinopathies
11Female
12Heart
13Humans
14Hyperaldosteronism - complications
15Hypertension - complications
16Hypertrophy, Left Ventricular - etiology
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18Medical sciences
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20Non tumoral diseases. Target tissue resistance. Benign neoplasms
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abstractA 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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pubAmerican Heart Association, Inc
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doi10.1161/HYPERTENSIONAHA.113.01060
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