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Cardiac Structure a...
Cardiac Structure and Function Across the Spectrum of Aldosteronism: the Atherosclerosis Risk in Communities Study
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- Brown, Jenifer M. (author)
- Brigham & Womens Hosp, MA 02115 USA
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- Wijkman, Magnus (author)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Medicinkliniken ViN,Brigham & Womens Hosp, MA 02115 USA
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- Claggett, Brian L. (author)
- Brigham & Womens Hosp, MA 02115 USA
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- Shah, Amil M. (author)
- Brigham & Womens Hosp, MA 02115 USA
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- Ballantyne, Christie M. (author)
- Baylor Coll Med, TX 77030 USA
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- Coresh, Josef (author)
- Johns Hopkins Bloomberg Sch Publ Hlth, MD USA
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- Grams, Morgan E. (author)
- Johns Hopkins Bloomberg Sch Publ Hlth, MD USA
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- Wang, Zhiying (author)
- Univ Texas Hlth Sci Ctr Houston, TX 77030 USA
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- Yu, Bing (author)
- Univ Texas Hlth Sci Ctr Houston, TX 77030 USA
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- Boerwinkle, Eric (author)
- Univ Texas Hlth Sci Ctr Houston, TX 77030 USA
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- Vaidya, Anand (author)
- Brigham & Womens Hosp, MA 02115 USA
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- Solomon, Scott D. (author)
- Brigham & Womens Hosp, MA 02115 USA
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(creator_code:org_t)
- LIPPINCOTT WILLIAMS & WILKINS, 2022
- 2022
- English.
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In: Hypertension. - : LIPPINCOTT WILLIAMS & WILKINS. - 0194-911X .- 1524-4563. ; 79:9, s. 1984-1993
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background: Aldosterone production and mineralocorticoid receptor activation are implicated in myocardial fibrosis and cardiovascular events. Methods: Cardiac structure and function were assessed in 4547 participants without prevalent heart failure (HF) in the ARIC study (Atherosclerosis Risk in Communities), with echocardiography, aldosterone, and plasma renin activity measurement (2011-2013). Subjects were characterized by plasma renin activity as suppressed (<= 0.5 ng/mL per hour) or unsuppressed (>0.5 ng/mL per hour). Cross-sectional relationships with cardiac structure and function, and longitudinal relationships with outcomes (HF hospitalization; HF and all-cause death; HF, death, myocardial infarction, and stroke; and incident atrial fibrillation) were assessed. Models were adjusted for demographic and anthropometric characteristics and additively, for blood pressure and antihypertensives. Results: Evidence of primary aldosteronism physiology was prevalent (11.6% with positive screen) and associated with echocardiographic parameters. Renin suppression was associated with greater left ventricular mass, left ventricular volumes, and left atrial volume index, and a lower E/A ratio (adjusted P<0.001 for all). Higher aldosterone was associated with greater left ventricular mass and lower global longitudinal strain and lateral E . The highest tertile of aldosterone was associated with a hazard ratio of 1.37 (95% CI, 1.06-1.77; 5.5-year follow-up) for incident atrial fibrillation relative to the lowest. Renin suppression was associated with HF (hazard ratio, 1.34 [95% CI, 1.05-1.72]; 7.3-year follow-up), although these relationships did not remain statistically significant after additional adjustment for hypertension. Conclusions: Renin suppression and aldosterone excess, consistent with primary aldosteronism pathophysiology, were associated with cardiac structural and functional alterations and may represent an early target for mitigation of fibrosis with mineralocorticoid receptor antagonists.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- aldosterone; echocardiography; heart failure; mineralocorticoids; renin
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Brown, Jenifer M ...
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Wijkman, Magnus
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Claggett, Brian ...
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Shah, Amil M.
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Ballantyne, Chri ...
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Coresh, Josef
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Grams, Morgan E.
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Wang, Zhiying
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Yu, Bing
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Boerwinkle, Eric
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Vaidya, Anand
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Solomon, Scott D ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Hypertension
- By the university
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Linköping University