Hypertension with primary aldosteronism is associated with increased carotid intima-media thickness and endothelial dysfunction.
Aldosterone
/ blood
Antihypertensive Agents
/ therapeutic use
Brachial Artery
/ diagnostic imaging
Carotid Arteries
/ diagnostic imaging
Carotid Intima-Media Thickness
Correlation of Data
Endothelium, Vascular
/ physiopathology
Female
Humans
Hyperaldosteronism
/ complications
Hypertension
/ diagnosis
Male
Middle Aged
aldosterone
carotid intima-media thickness
endothelial dysfunction
flow-mediated dilation
hypertension
primary aldosteronism
Journal
Journal of clinical hypertension (Greenwich, Conn.)
ISSN: 1751-7176
Titre abrégé: J Clin Hypertens (Greenwich)
Pays: United States
ID NLM: 100888554
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
03
01
2019
revised:
03
04
2019
accepted:
21
04
2019
pubmed:
13
6
2019
medline:
8
10
2020
entrez:
13
6
2019
Statut:
ppublish
Résumé
Patients with primary aldosteronism induced hypertension are more likely to experience cardiovascular events compared to patients with essential hypertension. Primary aldosteronism may therefore have distinct adverse effects on cardiovascular structure and function, independent of hypertension. However, current data on such effects of primary aldosteronism are conflicting. The aim of the present study was to investigate the influence of primary aldosteronism on vascular structure and endothelial function, using intima-media thickness as a vascular remodeling index and flow-mediated dilation as a functional parameter. In total, 70 participants were recruited from patients with resistant hypertension. Twenty-nine patients diagnosed with primary aldosteronism and 41 patients with essential hypertension were prospectively enrolled. Primary aldosteronism was due to aldosterone-producing adenoma in 10 cases and due to idiopathic adrenal hyperplasia in 19 cases. All patients underwent ultrasound of the common carotid intima-media thickness and flow-mediated dilation of the brachial artery. Primary aldosteronism patients had significantly lower flow-mediated dilation (3.3 [2.4-7.4] % vs 14.7 [10.3-19.9] %, P < 0.01) and significantly higher carotid intima-media thickness (0.9 [0.7-1.0] mm vs 0.8 [0.6-0.9] mm, P = 0.02) compared to patients with essential hypertension. These differences remained significant after adjusting for age, sex, diabetes mellitus, 24-hours systolic blood pressure, and smoking (P < 0.01). No differences in either outcome were observed between the adenoma and adrenal hyperplasia groups (both P > 0.05). Hypertensive patients with hyperaldosteronism appear to exhibit deteriorative effects on both vascular structure and function, independent of hypertension.
Identifiants
pubmed: 31187936
doi: 10.1111/jch.13585
pmc: PMC6771730
doi:
Substances chimiques
Antihypertensive Agents
0
Aldosterone
4964P6T9RB
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
932-941Informations de copyright
© 2019 The Authors. The Journal of Clinical Hypertension Published by Wiley Periodicals, Inc.
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