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...
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| Veröffentlicht in: | Hypertension (Dallas, Tex. 1979) Tex. 1979), 2013-08, Vol.62 (2), p.331-336 |
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| container_title | Hypertension (Dallas, Tex. 1979) |
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| creator | Savard, Sébastien Amar, Laurence Plouin, Pierre-François Steichen, Olivier |
| 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 |
| doi_str_mv | 10.1161/HYPERTENSIONAHA.113.01060 |
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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.</description><identifier>ISSN: 0194-911X</identifier><identifier>EISSN: 1524-4563</identifier><identifier>DOI: 10.1161/HYPERTENSIONAHA.113.01060</identifier><identifier>PMID: 23753408</identifier><identifier>CODEN: HPRTDN</identifier><language>eng</language><publisher>Hagerstown, MD: American Heart Association, Inc</publisher><subject>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</subject><ispartof>Hypertension (Dallas, Tex. 1979), 2013-08, Vol.62 (2), p.331-336</ispartof><rights>2013 American Heart Association, Inc</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3360-f511216a7ba81b204f22d3971f80b6c5bc70312117cd401b3e6f971fc183377e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27579335$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23753408$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Savard, Sébastien</creatorcontrib><creatorcontrib>Amar, Laurence</creatorcontrib><creatorcontrib>Plouin, Pierre-François</creatorcontrib><creatorcontrib>Steichen, Olivier</creatorcontrib><title>Cardiovascular Complications Associated With Primary Aldosteronism: A Controlled Cross-Sectional Study</title><title>Hypertension (Dallas, Tex. 1979)</title><addtitle>Hypertension</addtitle><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<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.</description><subject>Adrenals. Adrenal axis. Renin-angiotensin system (diseases)</subject><subject>Adult</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Coronary heart disease</subject><subject>Cross-Sectional Studies</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Hyperaldosteronism - complications</subject><subject>Hypertension - complications</subject><subject>Hypertrophy, Left Ventricular - etiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><issn>0194-911X</issn><issn>1524-4563</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkNGO1CAUhonRuOPqK5h6YeJN13OAQutd04zOJpvdjbNGvWoopRmUlhFaN_v2Ms6oiSSEcPj-A3yEvEK4QBT4dvP1dv3xbn29vby5rjd1KrILQBDwiKywoDznhWCPyQqw4nmF-OWMPIvxGwByzuVTckaZLBiHckWGRoXe-p8q6sWpkDV-3Dur1Wz9FLM6Rq-tmk2ffbbzLrsNdlThIatd7-Nsgp9sHN9ldYpNc_DOJbAJPsZ8a_ShhXLZdl76h-fkyaBcNC9O6zn59H5912zyq5sPl019lWvGBORDgUhRKNmpEjsKfKC0Z5XEoYRO6KLTElgiUOqeA3bMiOFwqrFkTErDzsmbY9998D8WE-d2tFEb59Rk_BJb5CBQirKUCa2OqD48OJih3R9_1yK0B83tf5pTkbW_Nafsy9M1Szea_m_yj9cEvD4BSaxyQ1CTtvEfJwtZMVYkjh-5e--Sz_jdLfcmtDuj3LxrIQ1ORZlTQAZl2uVpUmC_AIgbl4w</recordid><startdate>201308</startdate><enddate>201308</enddate><creator>Savard, Sébastien</creator><creator>Amar, Laurence</creator><creator>Plouin, Pierre-François</creator><creator>Steichen, Olivier</creator><general>American Heart Association, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201308</creationdate><title>Cardiovascular Complications Associated With Primary Aldosteronism: A Controlled Cross-Sectional Study</title><author>Savard, Sébastien ; Amar, Laurence ; Plouin, Pierre-François ; Steichen, Olivier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3360-f511216a7ba81b204f22d3971f80b6c5bc70312117cd401b3e6f971fc183377e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adrenals. Adrenal axis. Renin-angiotensin system (diseases)</topic><topic>Adult</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Coronary heart disease</topic><topic>Cross-Sectional Studies</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Hyperaldosteronism - complications</topic><topic>Hypertension - complications</topic><topic>Hypertrophy, Left Ventricular - etiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Savard, Sébastien</creatorcontrib><creatorcontrib>Amar, Laurence</creatorcontrib><creatorcontrib>Plouin, Pierre-François</creatorcontrib><creatorcontrib>Steichen, Olivier</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Savard, Sébastien</au><au>Amar, Laurence</au><au>Plouin, Pierre-François</au><au>Steichen, Olivier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiovascular Complications Associated With Primary Aldosteronism: A Controlled Cross-Sectional Study</atitle><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle><addtitle>Hypertension</addtitle><date>2013-08</date><risdate>2013</risdate><volume>62</volume><issue>2</issue><spage>331</spage><epage>336</epage><pages>331-336</pages><issn>0194-911X</issn><eissn>1524-4563</eissn><coden>HPRTDN</coden><abstract>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<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.</abstract><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>23753408</pmid><doi>10.1161/HYPERTENSIONAHA.113.01060</doi><tpages>6</tpages></addata></record> |
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| 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 |
| title | Cardiovascular Complications Associated With Primary Aldosteronism: A Controlled Cross-Sectional Study |
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