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Aldosterone dysregulation in essential hypertension
Javed Butler1, Kendall Hammonds2, Muhammad Sameer Arshad2
1Baylor Scott and White Research, Dallas, TX, United States..
The American Journal of Cardiology
|August 9, 2026
Summary
Aldosterone dysregulation is common in essential hypertension patients, linked to uncontrolled blood pressure. Current treatments may not fully resolve this hormonal imbalance, impacting blood pressure management.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Hypertension Research
Background:
- Aldosterone dysregulation is a key factor in poor blood pressure control for essential hypertension patients.
- Understanding the prevalence and impact of aldosterone dysregulation is crucial for effective hypertension management.
Purpose of the Study:
- To determine the prevalence of aldosterone dysregulation in essential hypertension.
- To assess the association between aldosterone dysregulation and uncontrolled blood pressure.
Main Methods:
- Retrospective analysis of electronic health records from 9129 adult patients with essential hypertension.
- Aldosterone dysregulation defined by aldosterone-to-renin ratio (ARR) >10 (PRA) or ARR >1 (PRC).
- Logistic regression models adjusted for diabetes, encounter type, potassium, and assay type.
Main Results:
- Aldosterone dysregulation was present in 39.4% of patients, more common in those with uncontrolled hypertension (41.5%).
- Associated with uncontrolled hypertension (OR 1.40) and stage 2 hypertension (OR 1.38).
- More prevalent in patients on multiple antihypertensive medications.
Conclusions:
- Aldosterone dysregulation is a frequent issue in essential hypertension, correlating with suboptimal blood pressure control.
- Existing treatments may be insufficient to correct aldosterone dysregulation.
- Further research into targeted therapies for aldosterone dysregulation is warranted.
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