Plasma aldosterone levels are associated with increased cardiovascular mortality: the Ludwigshafen Risk and...

Area of Science:

• Cardiovascular Medicine
• Endocrinology
• Clinical Research

Background:

• Elevated aldosterone is a known risk factor for cardiovascular events.
• The prognostic value of aldosterone levels within the normal range for mortality is not fully understood.

Purpose of the Study:

• To prospectively investigate the association between plasma aldosterone concentration (PAC) and all-cause and cardiovascular disease (CVD) mortality.
• To determine if PAC predicts mortality independently of established cardiovascular risk factors.

Main Methods:

• A cohort of 3153 patients undergoing coronary angiography was analyzed.
• Plasma aldosterone concentration (PAC) was measured and stratified into quartiles.
• Patients were followed prospectively for mortality outcomes, with adjustments for multiple risk factors using Cox proportional hazard models.

Main Results:

• Higher PAC levels, even within the normal range, were significantly associated with increased all-cause and CVD mortality.
• The highest quartile of PAC showed a 30% increased risk for all-cause mortality and a 58% increased risk for CVD mortality compared to the lowest quartile.
• Specific analyses indicated a strong link between PAC levels and fatal stroke and sudden cardiac death.

Conclusions:

• Plasma aldosterone concentration within the normal range is an independent predictor of all-cause and CVD mortality.
• These findings highlight the importance of monitoring aldosterone levels in patients at risk for cardiovascular events.