Higher Plasma Aldosterone Linked to 51% Increased CVD Risk in Hypertensive Patients
Photo by National Cancer Institute / Unsplash
Key Takeaway
Consider elevated plasma aldosterone as a potential risk marker for CVD in hypertensive patients, but recognize the association is observational.
This cohort study included 8653 hypertensive patients from a hypertension center and examined the association between plasma aldosterone concentration (PAC) and incident cardiovascular disease (CVD) over a median follow-up of 5.2 years. Patients were grouped by PAC quartiles, with the lowest quartile serving as the reference group.
The primary outcome was incident CVD, which occurred in 737 cases. Compared to the lowest PAC quartile, patients in the highest quartile had a 51% increased risk (HR 1.51; 95% CI 1.23–1.86). The study reports an association, not causation.
Safety and tolerability data were not reported. The study did not report on adverse events, serious adverse events, or discontinuations. Limitations were not explicitly listed, but as an observational study, residual confounding cannot be ruled out.
Clinically, these findings suggest that elevated PAC may be a marker of increased CVD risk in hypertensive patients. However, given the observational design, clinicians should interpret this association cautiously and not assume a causal relationship. Further research is needed to determine if targeting PAC can reduce CVD risk.
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View Original Abstract ↓
ObjectiveWhether plasma aldosterone concentration (PAC) is associated with incident cardiovascular disease (CVD) remains unclear in hypertensive patients, particularly after excluding those with primary aldosteronism. This study evaluates the association between PAC and incident CVD.MethodsThis study included hypertensive patients admitted to the hypertension center between January 1, 2014, and December 31, 2017, who had PAC measurements. Incident events encompassed both cardiac events and stroke. Cox proportional hazards models were used to evaluate the association between PAC and the outcome.ResultsA total of 8653 hypertensive patients were included in this study. During a median follow-up of 5.2 years, 737 cases of incident CVD occurred. The incidence of the outcome increased with higher quartiles of PAC. Individuals in the highest quartile of PAC had a 51% increased risk of CVD (HR 1.51, 95% CI 1.23–1.86) compared to those in the lowest quartile. The overall results remained stable and consistent in the stratification and sensitivity analyses.ConclusionsHigher PAC was associated with increased risk of CVD in hypertensive patients, irrespective of concomitant primary aldosteronism. These findings suggest that PAC might be a target for early prevention.
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