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Relationship between plasma aldosterone levels and arterial stiffness parameters in hypertensive patients with

L Petramala1, A Concistrè1, M Mezzadri1

  • 1Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy.

International Journal of Cardiology. Cardiovascular Risk and Prevention
|September 5, 2022
PubMed

Insights

Primary Aldosteronism (PA) patients exhibit greater arterial stiffness and subclinical cardiovascular damage than Essential Hypertension (EH) patients. Microalbuminuria (UAE) is a key indicator of this vascular remodeling.

Area of Science:

  • Cardiology
  • Endocrinology
  • Vascular Biology

Background:

  • Aldosterone significantly contributes to cardiovascular damage.
  • Essential Hypertension (EH) and Primary Aldosteronism (PA) are key conditions affecting cardiovascular health.
  • Subclinical arterial damage is an early indicator of cardiovascular risk.

Purpose of the Study:

  • To compare arterial subclinical damage using arterial stiffness parameters in patients with EH and PA.
  • To investigate the role of aldosterone in arterial damage.
  • To identify biomarkers for subclinical vascular remodeling.

Main Methods:

  • Non-invasive applanation tonometry was used to measure pressure waveforms.
  • 82 subjects were enrolled: 60 with EH, 22 with PA (including aldosterone-secreting adrenal adenoma - APA), and 40 normotensive subjects (NS).
  • Arterial stiffness index, carotid intima-media thickness (c-IMT), subendocardial viability ratio (SEVR), and travel time of reflected waves (TI) were assessed.

Main Results:

  • PA patients displayed higher microalbuminuria (UAE) compared to EH and NS groups.
  • The APA subgroup showed significantly increased arterial stiffness index, c-IMT, and reduced SEVR and TI compared to EH and NS.
  • PA patients exhibited a higher percentage of "worsening age" (60%) compared to EH (38%) and NS (37%).
  • Plasma aldosterone concentration (PAC) positively correlated with the Arterial Stiffness Index.
  • Microalbuminuria (UAE) was identified as a predictor of Augmentation Index, Arterial Stiffness Index, and Travel Time of reflected waves.

Conclusions:

  • Primary Aldosteronism patients exhibit greater subclinical cardiovascular damage than Essential Hypertension patients.
  • Microalbuminuria (UAE) excretion is significantly correlated with aldosterone levels.
  • UAE is the most effective marker for identifying subclinical vascular remodeling in these patient groups.
Abstract

Keywords:
Arterial stiffnessAtherosclerosisCardiovascular riskPrimary aldosteronismPulse wave velocity

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