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Aldosteronismo subclínico primario y eventos cardiovasculares adversos importantes: un estudio longitudinal de
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
Resumen
El aldosteronismo primario subclínico, indicado por una baja relación renina o alta relación aldosterona-renina, aumenta el riesgo de eventos cardiovasculares. Esta asociación es independiente de la presión arterial, lo que sugiere la necesidad de un cribado y tratamiento específicos.
Área de la Ciencia:
- Medicina cardiovascular
- Endocrinología
- Epidemiología
Sus antecedentes:
- El aldosteronismo primario (AP) está relacionado con un aumento de los eventos cardiovasculares.
- La PA subclínica, una forma más leve, es prevalente, pero su asociación con el riesgo cardiovascular no está clara.
Objetivo del estudio:
- Investigar la asociación entre los marcadores subclínicos del aldosteronismo primario y los eventos cardiovasculares adversos mayores (MACE).
Principales métodos:
- Estudio prospectivo de 2017 de adultos canadienses (40-69 años) de la cohorte CARTaGENE.
- Aldosterona, renina y relación entre aldosterona y renina (ARR) medidas al inicio del estudio.
- Vinculado a las bases de datos administrativas de la ECMA (infarto de miocardio, accidente cerebrovascular, hospitalización por insuficiencia cardíaca, muerte cardiovascular) durante un seguimiento mediano de 10,8 años.
Principales resultados:
- La disminución de la renina y el aumento de la RRA se asociaron con un mayor riesgo de ECMA, independientemente de la presión arterial.
- Se han identificado umbrales óptimos: renina ≤4,0 ng/L y ARR ≥70 pmol/L por ng/L, lo que predice un mayor riesgo de MACE.
- La concentración de aldosterona por sí sola no se asoció significativamente con el MACE.
Conclusiones:
- La AP subclínica, identificada por niveles específicos de renina y ARR, está asociada con un riesgo elevado de ECMA, independientemente de la presión arterial.
- Se necesita más investigación para confirmar si la detección temprana y el tratamiento de la AP subclínica pueden reducir el riesgo cardiovascular.
Palabras clave:
Aldosterona y sus derivadosRelación entre la aldosterona y la reninaacontecimientos cardiovascularessalud cardiovascularhiperaldosteronismohipertensiónAldosteronismo primarioel reninosubclínicasMás Videos Relacionados
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