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Cardiac Dimensions Are Largely Determined by Dietary Salt in Patients with Primary Aldosteronism: Results of a Case-Control Study

Context: Animal studies have demonstrated that dietary sodium intake is a major influence in the pathogenesis of aldosterone-induced effects in the heart such as left ventricular (LV) hypertrophy and fibrosis. LV hypertrophy is an important predictor for cardiovascular morbidity and mortality. Objec... Full description

Journal Title: The journal of clinical endocrinology and metabolism 2011, Vol.96 (9), p.2813-2820
Main Author: Pimenta, Eduardo
Other Authors: Gordon, Richard D , Ahmed, Ashraf H , Cowley, Diane , Leano, Rodel , Marwick, Thomas H , Stowasser, Michael
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Bethesda, MD: Endocrine Society
ID: ISSN: 0021-972X
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3167670
title: Cardiac Dimensions Are Largely Determined by Dietary Salt in Patients with Primary Aldosteronism: Results of a Case-Control Study
format: Article
creator:
  • Pimenta, Eduardo
  • Gordon, Richard D
  • Ahmed, Ashraf H
  • Cowley, Diane
  • Leano, Rodel
  • Marwick, Thomas H
  • Stowasser, Michael
subjects:
  • Abridged Index Medicus
  • Adrenals. Adrenal axis. Renin-angiotensin system (diseases)
  • Adult
  • Aged
  • Biological and medical sciences
  • Blood Pressure - drug effects
  • Case-Control Studies
  • Echocardiography
  • Endocrine Research
  • Endocrinopathies
  • Feeding. Feeding behavior
  • Female
  • Fundamental and applied biological sciences. Psychology
  • Heart - drug effects
  • Humans
  • Hyperaldosteronism - complications
  • Hyperaldosteronism - diagnostic imaging
  • Hyperaldosteronism - physiopathology
  • Hypertension - complications
  • Hypertension - diagnostic imaging
  • Hypertension - physiopathology
  • Hypertrophy, Left Ventricular - complications
  • Hypertrophy, Left Ventricular - diagnostic imaging
  • Hypertrophy, Left Ventricular - physiopathology
  • Male
  • Medical sciences
  • Middle Aged
  • Non tumoral diseases. Target tissue resistance. Benign neoplasms
  • Sodium Chloride, Dietary - pharmacology
  • Vertebrates: anatomy and physiology, studies on body, several organs or systems
  • Vertebrates: endocrinology
ispartof: The journal of clinical endocrinology and metabolism, 2011, Vol.96 (9), p.2813-2820
description: Context: Animal studies have demonstrated that dietary sodium intake is a major influence in the pathogenesis of aldosterone-induced effects in the heart such as left ventricular (LV) hypertrophy and fibrosis. LV hypertrophy is an important predictor for cardiovascular morbidity and mortality. Objective: We aimed to investigate the relationships between aldosterone and dietary salt and LV dimensions in patients with primary aldosteronism (PA). Design and Participants: This case-control study included 21 patients with confirmed PA and 21 control patients with essential hypertension matched for age, gender, duration of hypertension, and 24-h systolic and diastolic blood pressure. Main Outcome Measures: Patients were evaluated by echocardiography and 24-h urinary sodium (UNa) excretion while consuming their usual diets. Results: Patients with PA had significantly greater mean LV end-diastolic diameter, interventricular septum and posterior wall thicknesses, LV mass (LVM) and LV mass index, and end systolic and diastolic volumes than control patients. UNa significantly positively correlated with interventricular septum, posterior wall thicknesses, and LVM in the patients with PA but not in control patients. In a multivariate analysis, UNa was an independent predictor for LV wall thickness and LV mass among the patients with PA but not in patients with essential hypertension. Conclusions: These findings emphasize the importance of dietary sodium in determining the degree of cardiac damage in those patients with PA, and we suggest that aldosterone excess may play a permissive role. In patients with PA, because a high-salt diet is associated with greater LVM, dietary salt restriction might reduce cardiovascular risk.
language: eng
source:
identifier: ISSN: 0021-972X
fulltext: no_fulltext
issn:
  • 0021-972X
  • 1945-7197
url: Link


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titleCardiac Dimensions Are Largely Determined by Dietary Salt in Patients with Primary Aldosteronism: Results of a Case-Control Study
creatorPimenta, Eduardo ; Gordon, Richard D ; Ahmed, Ashraf H ; Cowley, Diane ; Leano, Rodel ; Marwick, Thomas H ; Stowasser, Michael
creatorcontribPimenta, Eduardo ; Gordon, Richard D ; Ahmed, Ashraf H ; Cowley, Diane ; Leano, Rodel ; Marwick, Thomas H ; Stowasser, Michael
descriptionContext: Animal studies have demonstrated that dietary sodium intake is a major influence in the pathogenesis of aldosterone-induced effects in the heart such as left ventricular (LV) hypertrophy and fibrosis. LV hypertrophy is an important predictor for cardiovascular morbidity and mortality. Objective: We aimed to investigate the relationships between aldosterone and dietary salt and LV dimensions in patients with primary aldosteronism (PA). Design and Participants: This case-control study included 21 patients with confirmed PA and 21 control patients with essential hypertension matched for age, gender, duration of hypertension, and 24-h systolic and diastolic blood pressure. Main Outcome Measures: Patients were evaluated by echocardiography and 24-h urinary sodium (UNa) excretion while consuming their usual diets. Results: Patients with PA had significantly greater mean LV end-diastolic diameter, interventricular septum and posterior wall thicknesses, LV mass (LVM) and LV mass index, and end systolic and diastolic volumes than control patients. UNa significantly positively correlated with interventricular septum, posterior wall thicknesses, and LVM in the patients with PA but not in control patients. In a multivariate analysis, UNa was an independent predictor for LV wall thickness and LV mass among the patients with PA but not in patients with essential hypertension. Conclusions: These findings emphasize the importance of dietary sodium in determining the degree of cardiac damage in those patients with PA, and we suggest that aldosterone excess may play a permissive role. In patients with PA, because a high-salt diet is associated with greater LVM, dietary salt restriction might reduce cardiovascular risk.
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subjectAbridged Index Medicus ; Adrenals. Adrenal axis. Renin-angiotensin system (diseases) ; Adult ; Aged ; Biological and medical sciences ; Blood Pressure - drug effects ; Case-Control Studies ; Echocardiography ; Endocrine Research ; Endocrinopathies ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Heart - drug effects ; Humans ; Hyperaldosteronism - complications ; Hyperaldosteronism - diagnostic imaging ; Hyperaldosteronism - physiopathology ; Hypertension - complications ; Hypertension - diagnostic imaging ; Hypertension - physiopathology ; Hypertrophy, Left Ventricular - complications ; Hypertrophy, Left Ventricular - diagnostic imaging ; Hypertrophy, Left Ventricular - physiopathology ; Male ; Medical sciences ; Middle Aged ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Sodium Chloride, Dietary - pharmacology ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology
ispartofThe journal of clinical endocrinology and metabolism, 2011, Vol.96 (9), p.2813-2820
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1Gordon, Richard D
2Ahmed, Ashraf H
3Cowley, Diane
4Leano, Rodel
5Marwick, Thomas H
6Stowasser, Michael
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descriptionContext: Animal studies have demonstrated that dietary sodium intake is a major influence in the pathogenesis of aldosterone-induced effects in the heart such as left ventricular (LV) hypertrophy and fibrosis. LV hypertrophy is an important predictor for cardiovascular morbidity and mortality. Objective: We aimed to investigate the relationships between aldosterone and dietary salt and LV dimensions in patients with primary aldosteronism (PA). Design and Participants: This case-control study included 21 patients with confirmed PA and 21 control patients with essential hypertension matched for age, gender, duration of hypertension, and 24-h systolic and diastolic blood pressure. Main Outcome Measures: Patients were evaluated by echocardiography and 24-h urinary sodium (UNa) excretion while consuming their usual diets. Results: Patients with PA had significantly greater mean LV end-diastolic diameter, interventricular septum and posterior wall thicknesses, LV mass (LVM) and LV mass index, and end systolic and diastolic volumes than control patients. UNa significantly positively correlated with interventricular septum, posterior wall thicknesses, and LVM in the patients with PA but not in control patients. In a multivariate analysis, UNa was an independent predictor for LV wall thickness and LV mass among the patients with PA but not in patients with essential hypertension. Conclusions: These findings emphasize the importance of dietary sodium in determining the degree of cardiac damage in those patients with PA, and we suggest that aldosterone excess may play a permissive role. In patients with PA, because a high-salt diet is associated with greater LVM, dietary salt restriction might reduce cardiovascular risk.
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4Biological and medical sciences
5Blood Pressure - drug effects
6Case-Control Studies
7Echocardiography
8Endocrine Research
9Endocrinopathies
10Feeding. Feeding behavior
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12Fundamental and applied biological sciences. Psychology
13Heart - drug effects
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15Hyperaldosteronism - complications
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17Hyperaldosteronism - physiopathology
18Hypertension - complications
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21Hypertrophy, Left Ventricular - complications
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24Male
25Medical sciences
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27Non tumoral diseases. Target tissue resistance. Benign neoplasms
28Sodium Chloride, Dietary - pharmacology
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titleCardiac Dimensions Are Largely Determined by Dietary Salt in Patients with Primary Aldosteronism: Results of a Case-Control Study
authorPimenta, Eduardo ; Gordon, Richard D ; Ahmed, Ashraf H ; Cowley, Diane ; Leano, Rodel ; Marwick, Thomas H ; Stowasser, Michael
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1Adrenals. Adrenal axis. Renin-angiotensin system (diseases)
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date2011-09
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abstractContext: Animal studies have demonstrated that dietary sodium intake is a major influence in the pathogenesis of aldosterone-induced effects in the heart such as left ventricular (LV) hypertrophy and fibrosis. LV hypertrophy is an important predictor for cardiovascular morbidity and mortality. Objective: We aimed to investigate the relationships between aldosterone and dietary salt and LV dimensions in patients with primary aldosteronism (PA). Design and Participants: This case-control study included 21 patients with confirmed PA and 21 control patients with essential hypertension matched for age, gender, duration of hypertension, and 24-h systolic and diastolic blood pressure. Main Outcome Measures: Patients were evaluated by echocardiography and 24-h urinary sodium (UNa) excretion while consuming their usual diets. Results: Patients with PA had significantly greater mean LV end-diastolic diameter, interventricular septum and posterior wall thicknesses, LV mass (LVM) and LV mass index, and end systolic and diastolic volumes than control patients. UNa significantly positively correlated with interventricular septum, posterior wall thicknesses, and LVM in the patients with PA but not in control patients. In a multivariate analysis, UNa was an independent predictor for LV wall thickness and LV mass among the patients with PA but not in patients with essential hypertension. Conclusions: These findings emphasize the importance of dietary sodium in determining the degree of cardiac damage in those patients with PA, and we suggest that aldosterone excess may play a permissive role. In patients with PA, because a high-salt diet is associated with greater LVM, dietary salt restriction might reduce cardiovascular risk.
copBethesda, MD
pubEndocrine Society
pmid21632817
doi10.1210/jc.2011-0354
oafree_for_read