Treated primary hyperaldosteronism patients had significantly higher depression scores than normotensive controls (4 vs 1, p=0.03), though overall cognitive function was preserved.
Cross-Sectional (n=63)
Does adequate treatment of primary hyperaldosteronism preserve cognitive function and affect psychological symptoms compared to essential hypertension and normotensive controls?
Guideline-concordant treatment of primary hyperaldosteronism preserves cognitive function, though patients continue to experience elevated depressive symptoms requiring comprehensive psychological care.
Absolute Event Rate: 4% vs 1%
p-value: p=0.03
Objective: Primary hyperaldosteronism, one of the most common causes of secondary hypertension, has been associated with cognitive impairment and psychological symptoms. However, the cognitive profile of adequately treated patients remains unclear. This study investigated cognitive functions and affective symptoms in patients with treated primary hyperaldosteronism compared to essential hypertension patients and normotensive controls.Design and method: This cross-sectional study enrolled 63 participants divided into three groups of 21 each: primary hyperaldosteronism patients (7 post-adrenalectomy, 14 on mineralocorticoid receptor antagonists), essential hypertension patients, and normotensive controls. Groups were matched for age, sex, and educational level; hypertensive groups were additionally matched for hypertension duration. Assessments included ambulatory blood pressure monitoring and comprehensive neuropsychological evaluation (21 variables including California Verbal Learning Test, Trail Making Test, Verbal Fluency Test, and Hospital Anxiety and Depression Scale). Results: Non-significant trends toward poorer performance in primary hyperaldosteronism were observed in executive function and attention domains. Primary hyperaldosteronism patients exhibited significantly higher depression scores than controls (4±1.5 vs. 1±1.5, p=0.03), with no group differences in anxiety. Essential hypertension patients showed significantly worse immediate verbal recall (CVLT Trial 1) compared to controls (p=0.02), while primary hyperaldosteronism patients did not differ significantly from either group despite higher disease burden. Conclusions: Guideline-concordant treatment, including adrenalectomy or mineralocorticoid receptor antagonist therapy, preserves overall cognitive function in primary hyperaldosteronism. However, elevated depressive symptoms persist despite adequate disease management, indicating that comprehensive care must extend beyond blood pressure control to include psychological assessment and support.
Nieckarz et al. (Fri,) conducted a cross-sectional in Primary hyperaldosteronism (n=63). Treated primary hyperaldosteronism vs. Essential hypertension and normotensive controls was evaluated on Depression scores (p=0.03). Treated primary hyperaldosteronism patients had significantly higher depression scores than normotensive controls (4 vs 1, p=0.03), though overall cognitive function was preserved.