Target organ damage in untreated hypertensive patients with primary aldosteronism

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Vol. 26; no. 7; pp. 789 - 796
• Main Authors: Li, Shi‐Min, Huang, Jia‐Yi, Zhu, Ching‐Yan, Ng, Ming‐Yen, Lin, Qing‐Shan, Wu, Min, Liu, Ming‐Ya, Wang, Run, Cao, Gao‐Zhen, Chen, Cong, Wu, Mei‐Zhen, Ren, Qing‐Wen, Tse, Hung‐Fat, Yiu, Kai‐Hang
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.07.2024; John Wiley and Sons Inc; Wiley
• Subjects: Adult; Aged; Albuminuria - diagnosis; Albuminuria - epidemiology; Albuminuria - etiology; Blood pressure; Blood Pressure - physiology; Body mass index; Cardiovascular disease; Carotid arteries; Carotid Intima-Media Thickness; Cholesterol; Creatinine; Diabetes; Female; Hong Kong - epidemiology; Humans; Hyperaldosteronism - complications; Hyperaldosteronism - diagnosis; Hyperaldosteronism - epidemiology; Hypertension; Hypertension - complications; Hypertension - epidemiology; Hypertrophy, Left Ventricular - diagnosis; Hypertrophy, Left Ventricular - epidemiology; Hypertrophy, Left Ventricular - etiology; Hypertrophy, Left Ventricular - physiopathology; Hypokalemia - diagnosis; Hypokalemia - epidemiology; Hypokalemia - etiology; Male; Middle Aged; Original; Prevalence; primary aldosteronism; Risk Factors; Statistical analysis; target organ damage; Ultrasonic imaging; untreated hypertension; Veins & arteries; Hong Kong; China; target organ damage; untreated hypertension; primary aldosteronism
• ISSN: 1524-6175; 1751-7176; 1751-7176
• DOI: 10.1111/jch.14794

An increased risk of target organ damage (TOD) has been reported in patients with primary aldosteronism (PA). However, there is relatively little related research on the correlation between the degree of TOD and those with and without PA in newly diagnosed hypertensive patients. The aim of this study was to assess the association between PA and TOD among patients with newly diagnosed hypertension. Newly diagnosed hypertensive patients were consecutively recruited from January 2015 to June 2020 at the University of Hong Kong‐Shenzhen Hospital. Patients were stratified into those with and without PA. Data for left ventricular mass index (LVMI), carotid intima‐media thickness (CIMT) and plaque, and microalbuminuria were systematically collected. A total of 1044 patients with newly diagnosed hypertension were recruited, 57 (5.5%) of whom were diagnosed with PA. Patients with PA had lower blood pressure, serum lipids, body mass index, and plasma renin activity and a higher incidence of hypokalemia than those without PA. In contrast, the prevalence of left ventricular hypertrophy, increased CIMT, and microalbuminuria was higher in patients with PA than in those without PA. Multivariable regression analysis demonstrated that PA was independently associated with increased LVMI, CIMT and microalbuminuria. Among patients with newly diagnosed hypertension, those with PA had more severe TOD, including a higher LVMI, CIMT and microalbuminuria, than those without PA. These findings emphasize the need for screening TOD in newly diagnosed hypertension due to underlying PA.