Renin, a marker for left ventricular hypertrophy, in primary aldosteronism: a cohort study

Köhler, Anton; Sarkis, Anna-Lina; Heinrich, Daniel A.; Müller, Lisa Marie; Handgriff, Laura; Deniz, Sinan; Schneider, Holger; Künzel, Heike; Ladurner, Roland; Reincke, Martín; Adolf, Christian

doi:10.1530/eje-21-0018

Cited by 16 publications

(5 citation statements)

References 41 publications

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“…Notably, the PA patients treated with adrenalectomy experienced lower rates of cardiovascular events than even patients with essential hypertension (HR 0.58 [95% CI 0.35-0.97]) ( 22 ). Similar benefits to adrenalectomy over MR antagonist therapy for PA has also been demonstrated in atrial fibrillation ( 21 , 26 ) and left ventricular hypertrophy ( 72 , 73 ).…”

Section: Clinical Outcomes Following Surgical Adrenalectomy For Unila...supporting

confidence: 54%

Benefits of Surgical Over Medical Treatment for Unilateral Primary Aldosteronism

Ahmed

Hundemer

2022

Front. Endocrinol.

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Primary aldosteronism is the most common and modifiable form of secondary hypertension. Left untreated, primary aldosteronism leads high rates of cardiovascular, metabolic, and kidney disease. Therefore, early diagnosis and targeted therapy are crucial to improve long-term patient outcomes. In the case of unilateral primary aldosteronism, surgical adrenalectomy is the guideline-recommended treatment of choice as compared to alternative medical therapies such as mineralocorticoid receptor antagonist medications. Surgical adrenalectomy is not only highly successful in reversing the biochemical abnormalities inherent to primary aldosteronism, but also in mitigating the long-term risks associated with this disease. Indeed, as opposed to medical treatment alone, surgical adrenalectomy offers the potential for disease cure. Within this review article, we review the existing evidence highlighting the benefits of surgical over medical treatment for unilateral primary aldosteronism.

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Section: Clinical Outcomes Following Surgical Adrenalectomy For Unila...supporting

confidence: 54%

Benefits of Surgical Over Medical Treatment for Unilateral Primary Aldosteronism

Ahmed

Hundemer

2022

Front. Endocrinol.

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“…Persistently low plasma renin was also associated with persistent LV hypertrophy, and was an independent confounder of persistently low LV midwall function, adding to a recent publication by Köhler et al. [35].…”

Section: Discussionmentioning

confidence: 55%

“…This might reflect adverse effects of MRA treatment, physician inertia or poor patient drug adherence, all major problems in management of hypertension [34]. Persistently low plasma renin was also associated with persistent LV hypertrophy, and was an independent confounder of persistently low LV midwall function, adding to a recent publication by Ko ¨hler et al [35].…”

Section: Discussionmentioning

confidence: 80%

Persistent cardiac organ damage in surgically and medically treated primary aldosteronism

Aune

Gerdts²,

Kokorina³

et al. 2022

Journal of Hypertension

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Objective: We compared persistent cardiac organ damage in patients treated surgically or medically for primary aldosteronism.Methods: Eighty-four patients (age 57 AE 11 years, 27% women) with primary aldosteronism underwent echocardiography at time of diagnosis and after one year of treatment (49% adrenalectomy, 51% medical treatment). Persistent cardiac organ damage was defined as presence of left ventricle (LV) hypertrophy, low LV midwall shortening, global longitudinal strain and/or enlarged left atrium both at baseline and at follow-up.Results: At one year, a significant regression of LV hypertrophy was observed in surgically (44 vs. 22%, P ¼ 0.039), but not in medically treated patients (60 vs. 51%, P ¼ 0.206). The prevalence of enlarged left atrium was reduced in both groups (both P < 0.001), whereas systolic myocardial function remained unchanged. In multivariable logistic regression analysis, medical treatment [odds ratio (OR) 4.88 (95% confidence interval (CI) 1.26-18.88)] was a strong predictor of persistent LV hypertrophy independent of higher BMI ] and presence of diabetes ), all P < 0.05]. Persistently low midwall shortening was associated with suppressed plasma renin after one year ] and lower renal function [OR 0.96 (95% CI 0.94-0.99), both P < 0.05]. The strongest predictor of persistently low global longitudinal strain was higher HbA 1c [OR 2.37 (95% CI 1.12-5.02), P ¼ 0.024]. Conclusion:Persistent cardiac organ damage was more common in the medical treatment group and associated with incomplete aldosterone blockade, impaired renal function and presence of metabolic comorbidities.

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“…Cardiovascular diseases are included in the category of coronary atherosclerotic heart disease (coronary heart disease) and stroke [ 26 ]. Among them, coronary heart disease includes two types of stable angina pectoris and myocardial infarction [ 27 ].…”

Section: Methods Of Pa Functional Diagnostic Test Reliability Based O...mentioning

confidence: 99%

Reliability Analysis of a Functional Diagnostic Test for Primary Hyperaldosteronism Based on Data Analysis

Wang

Cai

2022

Computational Intelligence and Neuroscience

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Primary aldosteronism (PA) is one of the most common causes of secondary hypertension, with a prevalence of 12–20% in the hypertensive population. To determine the characteristic function of a fuzzy concept based on the epidemiological data, clinical manifestations, and auxiliary examinations of PA, the essence is to select a suitable domain and determine the affiliation of each element in the domain. The aldosterone/renin ratio was proposed to increase the detection rate of PA, which has the shortcoming of a high underdiagnosis rate when relying only on clinical manifestations. However, there is no unified standard for the diagnostic cut point, and there are differences in testing methods and diagnostic cut point values for different populations, which require different laboratories to establish appropriate cut points according to different regional populations to improve the diagnostic accuracy. In this article, we analyzed the reliability of functional diagnostic tests for PA based on data analysis and compared the sensitivity and specificity of different plasma aldosterone cut points for the diagnosis of PA in the 40 mg kibbutz test. The results showed that when post-saline PAC and post-cato PAC were used to confirm the diagnosis of proaldosterone, respectively, there was a similar subject working area under the curve between SSST and CCT, 0.89 and 0.78, respectively, with no significant difference in the area under the curve between the two ( p = 0.546 ). Therefore, blood sodium and blood potassium have higher specificity and sensitivity than SUSPUP, but both are lower than ARR, and data analysis can be used as an auxiliary indicator for screening.

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Renin, a marker for left ventricular hypertrophy, in primary aldosteronism: a cohort study

Cited by 16 publications

References 41 publications

Benefits of Surgical Over Medical Treatment for Unilateral Primary Aldosteronism

Benefits of Surgical Over Medical Treatment for Unilateral Primary Aldosteronism

Persistent cardiac organ damage in surgically and medically treated primary aldosteronism

Reliability Analysis of a Functional Diagnostic Test for Primary Hyperaldosteronism Based on Data Analysis

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