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Obesity-Related Aldosteronism is Associated with Adverse Cardiac Structure, Function, and Adiposity
Medrxiv : the Preprint Server for Health Sciences
|November 26, 2025
Summary
Obesity-related aldosteronism is common in hypertensive adults and linked to heart problems and increased visceral fat. This suggests aldosterone excess may drive obesity-related heart disease.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Syndrome
Background:
- Obesity-related aldosteronism may increase cardiometabolic risk.
- Investigated the link between aldosterone dysregulation and cardiometabolic outcomes in obese hypertensive adults.
Purpose of the Study:
- To investigate the association between dysregulated aldosterone production and cardiac structure, function, and adiposity.
- To assess aldosterone production under controlled physiological conditions in obese hypertensive adults.
Main Methods:
- Prospective enrollment of obese hypertensive participants.
- Comprehensive phenotyping of aldosterone production via four controlled physiological maneuvers (SST, OSLT, DST, ACTH stimulation).
- Cardiac and abdominal MRI for assessing cardiac structure, function, cardiac fat, hepatic fat, and visceral-to-subcutaneous fat ratio.
Main Results:
- 29.2% of participants had overt primary aldosteronism.
- Higher aldosterone levels correlated with increased left ventricular mass index, impaired global longitudinal strain, cardiac fat volume, and visceral-to-subcutaneous fat ratio.
- Associations were consistent across different aldosterone stimulation/suppression tests.
Conclusions:
- Dysregulated aldosterone production and primary aldosteronism are prevalent in obese hypertensive adults.
- These conditions are independently associated with adverse cardiac remodeling and increased cardiometabolic adipose tissue.
- Findings suggest a pathophysiologic link between aldosterone excess and obesity-related cardiometabolic disease.
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