Serum Aldosterone Is Related to Left Ventricular Geometry and Function in Young Adults with Never-Treated Primary Hypertension

Overview

Journal J Clin Med

Specialty General Medicine

Date 2019 Jul 20

PMID 31319630

Citations 5

Authors

Seong-Mi Park

Mi-Na Kim

Sua Kim

Wan-Joo Shim

Affiliations

Soon will be listed here.

Abstract

Background: Although aldosterone has been demonstrated to induce left ventricular (LV) hypertrophy not only in primary aldosteronism but also in primary hypertension (HT), it can be affected by multiple factors, including age, and the effect of aldosterone on LV function is controversial. This study was to investigate the relationship of aldosterone to changes in LV geometry and function in young adults with never-treated HT.

Methods: Seventy-five consecutive patients (age, 29.8 ± 6.3 years) with never-treated HT and 45 normal controls were enrolled. Echocardiographic values and LV global longitudinal strain (LVGLS) were obtained. Serum aldosterone concentration (SAC) and serum procollagen type III amino-terminal peptide (PIIINP) level were obtained in HT patients.

Results: HT patients had higher LV mass index, higher relative wall thickness (RWT), and worse LV function than normal controls. LVGLS and e' velocity were worse in HT patients with normal geometry than in normal controls. SAC was well correlated with LV mass index, RWT, e' velocity, LVGLS, and PIIINP (all < 0.05). LV geometry pattern was most related to SAC among clinical parameters ( = 0.019). LVGLS was most related to LV geometry and diastolic blood pressure. In contrast, e' velocity was most related to PIIINP.

Conclusion: Our findings may indicate that in young patients with never-treated HT, aldosterone significantly contributes to changes in LV geometry and functional impairment through its pro-hypertrophic and myocardial fibrosis effects beyond blood pressure.

Citing Articles

Aldosterone Effect on Cardiac Structure and Function.

Al-Hashedi E, Abdu F Curr Cardiol Rev. 2024; 20(4):e290224227534.

PMID: 38425104 PMC: 11327832. DOI: 10.2174/011573403X281390240219063817.

Macula Densa Nitric Oxide Synthase 1 Controls Renin Release and Renin-Dependent Blood Pressure Changes.

Liu C, Wang X, Parris C, Pang Q, Naeem M, Wang L Discov Med. 2023; 35(177):525-532.

PMID: 37553306 PMC: 10921921. DOI: 10.24976/Discov.Med.202335177.53.

Serum aldosterone effect on left ventricular structure and diastolic function in essential hypertension.

Al-Hashedi E, Zhao X, Mohammed A, Juvenal H, Yu J J Clin Hypertens (Greenwich). 2022; 25(2):213-222.

PMID: 36585812 PMC: 9903192. DOI: 10.1111/jch.14612.

Glucose dysregulation and subclinical cardiac dysfunction in older adults: The Cardiovascular Health Study.

Garg P, Biggs M, Kizer J, Shah S, Psaty B, Carnethon M Cardiovasc Diabetol. 2022; 21(1):112.

PMID: 35725477 PMC: 9210635. DOI: 10.1186/s12933-022-01547-z.

Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community.

Hirose K, Nakanishi K, Daimon M, Sawada N, Yoshida Y, Iwama K Cardiovasc Diabetol. 2021; 20(1):22.

PMID: 33478525 PMC: 7818760. DOI: 10.1186/s12933-020-01201-6.

References

Gottdiener J, Arnold A, Aurigemma G, Polak J, Tracy R, Kitzman D . Predictors of congestive heart failure in the elderly: the Cardiovascular Health Study. J Am Coll Cardiol. 2000; 35(6):1628-37. DOI: 10.1016/s0735-1097(00)00582-9. View

Tanaka T, Okamura T, Miura K, Kadowaki T, Ueshima H, Nakagawa H . A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen. J Hum Hypertens. 2002; 16(2):97-103. DOI: 10.1038/sj.jhh.1001307. View

McCarron P, Okasha M, McEwen J, Davey Smith G . Blood pressure in early life and cardiovascular disease mortality. Arch Intern Med. 2002; 162(5):610-1. DOI: 10.1001/archinte.162.5.610. View

Iwashima Y, Horio T, Kuroda S, Takishita S, Kawano Y . Influence of plasma aldosterone on left ventricular geometry and diastolic function in treated essential hypertension. Hypertens Res. 2002; 25(1):49-56. DOI: 10.1291/hypres.25.49. View

Rossi G, Di Bello V, Ganzaroli C, Sacchetto A, Cesari M, Bertini A . Excess aldosterone is associated with alterations of myocardial texture in primary aldosteronism. Hypertension. 2002; 40(1):23-7. DOI: 10.1161/01.hyp.0000023182.68420.eb. View

Seifarth C, Trenkel S, Schobel H, Hahn E, Hensen J . Influence of antihypertensive medication on aldosterone and renin concentration in the differential diagnosis of essential hypertension and primary aldosteronism. Clin Endocrinol (Oxf). 2002; 57(4):457-65. DOI: 10.1046/j.1365-2265.2002.01613.x. View

Rocha R, Funder J . The pathophysiology of aldosterone in the cardiovascular system. Ann N Y Acad Sci. 2002; 970:89-100. DOI: 10.1111/j.1749-6632.2002.tb04415.x. View

Sato A, Hayashi M, Saruta T . Relative long-term effects of spironolactone in conjunction with an angiotensin-converting enzyme inhibitor on left ventricular mass and diastolic function in patients with essential hypertension. Hypertens Res. 2002; 25(6):837-42. DOI: 10.1291/hypres.25.837. View

Kozakova M, Buralli S, Palombo C, Bernini G, Moretti A, Favilla S . Myocardial ultrasonic backscatter in hypertension: relation to aldosterone and endothelin. Hypertension. 2003; 41(2):230-6. DOI: 10.1161/01.hyp.0000052542.68896.2b. View

10.

Pitt B, Reichek N, Willenbrock R, Zannad F, Phillips R, Roniker B . Effects of eplerenone, enalapril, and eplerenone/enalapril in patients with essential hypertension and left ventricular hypertrophy: the 4E-left ventricular hypertrophy study. Circulation. 2003; 108(15):1831-8. DOI: 10.1161/01.CIR.0000091405.00772.6E. View

11.

Muiesan M, Salvetti M, Monteduro C, Bonzi B, Paini A, Viola S . Left ventricular concentric geometry during treatment adversely affects cardiovascular prognosis in hypertensive patients. Hypertension. 2004; 43(4):731-8. DOI: 10.1161/01.HYP.0000121223.44837.de. View

12.

Mattsson C, Young Jr W . Primary aldosteronism: diagnostic and treatment strategies. Nat Clin Pract Nephrol. 2006; 2(4):198-208. DOI: 10.1038/ncpneph0151. View

13.

Berk B, Fujiwara K, Lehoux S . ECM remodeling in hypertensive heart disease. J Clin Invest. 2007; 117(3):568-75. PMC: 1804378. DOI: 10.1172/JCI31044. View

14.

Nakahara T, Takata Y, Hirayama Y, Asano K, Adachi H, Shiokawa G . Left ventricular hypertrophy and geometry in untreated essential hypertension is associated with blood levels of aldosterone and procollagen type III amino-terminal peptide. Circ J. 2007; 71(5):716-21. DOI: 10.1253/circj.71.716. View

15.

Catena C, Colussi G, Lapenna R, Nadalini E, Chiuch A, Gianfagna P . Long-term cardiac effects of adrenalectomy or mineralocorticoid antagonists in patients with primary aldosteronism. Hypertension. 2007; 50(5):911-8. DOI: 10.1161/HYPERTENSIONAHA.107.095448. View

16.

Weber K, Brilla C . Pathological hypertrophy and cardiac interstitium. Fibrosis and renin-angiotensin-aldosterone system. Circulation. 1991; 83(6):1849-65. DOI: 10.1161/01.cir.83.6.1849. View

17.

Mule G, Nardi E, Cusimano P, Cottone S, Seddio G, Geraci C . Plasma aldosterone and its relationships with left ventricular mass in essential hypertensive patients with the metabolic syndrome. Am J Hypertens. 2008; 21(9):1055-61. DOI: 10.1038/ajh.2008.225. View

18.

Muiesan M, Salvetti M, Paini A, Agabiti-Rosei C, Monteduro C, Galbassini G . Inappropriate left ventricular mass in patients with primary aldosteronism. Hypertension. 2008; 52(3):529-34. DOI: 10.1161/HYPERTENSIONAHA.108.114140. View

19.

Velagaleti R, Gona P, Levy D, Aragam J, Larson M, Tofler G . Relations of biomarkers representing distinct biological pathways to left ventricular geometry. Circulation. 2008; 118(22):2252-8, 5p following 2258. PMC: 2747641. DOI: 10.1161/CIRCULATIONAHA.108.817411. View

20.

Levey A, Stevens L, Schmid C, Zhang Y, Castro 3rd A, Feldman H . A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009; 150(9):604-12. PMC: 2763564. DOI: 10.7326/0003-4819-150-9-200905050-00006. View