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A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
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Subclinical Primary Aldosteronism and Major Adverse Cardiovascular Events: A Longitudinal Population-Based Cohort
Rémi Goupil1,2,3, Louis-Charles Desbiens2, Amel Merabtine3
1Hôpital de Sacré-Cœur de Montréal, CIUSSS-du-Nord-de-l'île-de-Montréal, Montreal, QC, Canada (R.G., F.M.).
Circulation
|July 9, 2025
Summary
Subclinical primary aldosteronism, indicated by low renin or high aldosterone-to-renin ratio, increases cardiovascular event risk. This association is independent of blood pressure, suggesting a need for targeted screening and treatment.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Epidemiology
Background:
- Primary aldosteronism (PA) is linked to increased cardiovascular events.
- Subclinical PA, a milder form, is prevalent but its association with cardiovascular risk is unclear.
Purpose of the Study:
- To investigate the association between subclinical primary aldosteronism markers and major adverse cardiovascular events (MACE).
Main Methods:
- Prospective study of 2017 Canadian adults (40-69 years) from the CARTaGENE cohort.
- Measured aldosterone, renin, and aldosterone-to-renin ratio (ARR) at baseline.
- Linked to administrative databases for MACE (myocardial infarction, stroke, heart failure hospitalization, cardiovascular death) over 10.8 years median follow-up.
Main Results:
- Lower renin and higher ARR were associated with increased MACE risk, independent of blood pressure.
- Optimal thresholds identified: renin ≤4.0 ng/L and ARR ≥70 pmol/L per ng/L predicted higher MACE risk.
- Aldosterone concentration alone was not significantly associated with MACE.
Conclusions:
- Subclinical PA, identified by specific renin and ARR levels, is associated with elevated MACE risk, independent of blood pressure.
- Further research is needed to confirm if early detection and treatment of subclinical PA can reduce cardiovascular risk.
Keywords:
aldosteronealdosterone-to-renin ratiocardiovascular eventscardiovascular healthhyperaldosteronismhypertensionprimary aldosteronismreninsubclinicalMore Related Videos
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