In patients with suspected primary hyperaldosteronism, 41.0% had ≥1 major cardiometabolic complication, with multiple complications rising from 14.3% in Stage I to 56.8% in resistant hypertension.
Cohort (n=117)
No
Primary hyperaldosteronism is associated with a substantial burden of cardiometabolic complications, particularly in older patients and those with resistant hypertension.
Objective: Primary hyperaldosteronism (PA) is one of the most common causes of secondary hypertension and is associated with excess cardiovascular and metabolic risk. Data from South-Eastern Europe, particularly from certified centers of excellence, are limited. Design and method: We conducted a retrospective analysis of 117 consecutive patients with suspected PA evaluated between 2015 and 2025 at an Internal Medicine Department accredited as a Hypertension Excellence Centre by the European Society of Hypertension (ESH). Demographic characteristics, body mass index (BMI), hypertension (HTN) stage, Angio-CT findings, treatment modality, and cardiometabolic complications were recorded. Major complications were defined as diabetes mellitus (DM), ischemic heart disease (IHD), stroke, or heart failure. Patients were stratified by HTN stage and age group. Results: The cohort included 66 men (56.4%) and 51 women (43.6%), with a mean age of 51.1 years (range 15–76) and mean BMI of 28.5 kg/m2. HTN stages were: Stage I 12.0%, Stage II 29.9%, Stage III 20.5%, and resistant HTN 37.6%. Angio-CT demonstrated left-sided adenoma in 49.6%, right-sided in 29.9%, and bilateral disease in 20.5%. DM was present in 29.9% of patients (plus impaired glucose tolerance in 11.1%), IHD in 13.7%, stroke in 11.1%, and heart failure in 10.3%. At least one major cardiometabolic complication was observed in 41.0% of patients and more than two in 14.5%. Diastolic dysfunction was detected in 47.9%. A strong gradient was observed across HTN stages, with more than one major complication increasing from 14.3% in Stage I to 56.8% in resistant HTN. Patients aged >55 years exhibited the highest burden of multimorbidity. Conclusions: In this real-world cohort from an ESH Hypertension Excellence Centre, PA was associated with a substantial burden of cardiometabolic complications, particularly in patients with advanced or resistant hypertension and older age. Early identification of PA and integrated cardiometabolic risk assessment should be a priority in specialized hypertension centers.
Kecaj et al. (Fri,) conducted a cohort in Primary hyperaldosteronism (n=117). Primary hyperaldosteronism was evaluated on At least one major cardiometabolic complication. In patients with suspected primary hyperaldosteronism, 41.0% had ≥1 major cardiometabolic complication, with multiple complications rising from 14.3% in Stage I to 56.8% in resistant hypertension.