Subclinical hyperaldosteronism was linked to increased LV mass (b=1.43), end-diastolic volume (b=0.67), and worse diastolic function in 3859 adults without CVD.
Is subclinical primary hyperaldosteronism associated with adverse echocardiographic heart remodeling parameters in a general population without known cardiovascular disease?
Subclinical hyperaldosteronism is associated with increased left ventricular mass, increased indexed volume, and worse diastolic function in a general population without known cardiovascular disease.
Abstract Background Primary aldosteronism (PA) is a state of autonomous, renin-independent aldosterone production. Mild PA phenotypes, featuring suppressed renin levels, are prevalent and independently linked to hypertension. Limited research has explored their association with cardiac remodelling in the absence of other known cardiovascular diseases (CVD). Purpose Explore associations of mild PA and heart remodelling parameters in the absence of cardiovascular disease (CVD). Methods Using data from the Generation 3 of the Framingham Heart Study, we selected participants with available baseline levels of aldosterone and renin and echocardiography (2002–2005). Participants with known CVD or taking mineralocorticoid receptor antagonists (MRA) were excluded. Linear and logistic regressions adjusted for relevant covariates were performed to evaluate the association of renin/aldosterone ratio with echocardiographic parameters. Results We included 3859 individuals (mean age 40.0±8.8years; 54% female; mean BMI 26.8), of whom 12% had hypertension and 2.7% had diabetes. Adjusted for age, sex, body mass index and systolic blood pressure, renin/aldosterone ratio had a significant positive correlation with left ventricle (LV) mass (b=1.43 0.82-2.05), E/e’ ratio (b=0.02 0.01-0.03) and isovolumetric relaxation time (b=0.54 0.08-0.99). There was no correlation with LV ejection fraction (b=-0.01 -0.11-0.09). Adjusted for age, sex and systolic blood pressure, renin/aldosterone ratio had a significant positive association left ventricle (LV) end-diastolic indexed volume (b=0.67 0.41-0.93). Conclusions Subclinical hyperaldosteronism was associated with increased LV mass and indexed volume and worse diastolic function. Subclinical hyperaldosteronism may play an unrecognized role in the development of cardiovascular diseases in the general population.
Adão et al. (2025) studied this question. Subclinical hyperaldosteronism was linked to increased LV mass (b=1.43), end-diastolic volume (b=0.67), and worse diastolic function in 3859 adults without CVD.
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