Key result
Women with primary aldosteronism exhibit worse baseline LVH and less post-treatment diastolic improvement than men.
Why the study?
The role of sex differences in aldosterone-mediated cardiac remodeling in primary aldosteronism remains incompletely understood.
Does sex influence cardiac remodeling and diastolic function improvement following aldosterone-targeted therapies in patients with primary aldosteronism?
Does sex influence cardiac remodeling and diastolic function improvement following aldosterone-targeted therapies in patients with primary aldosteronism?
Women with primary aldosteronism exhibit a more adverse baseline cardiac phenotype and experience less improvement in diastolic function after targeted therapy compared to men.
May warrant closer diastolic monitoring in women with primary aldosteronism; leaves open sex-specific therapy optimization.
BACKGROUND: Sex differences influence cardiovascular risk assessment and management; however, their role in aldosterone-mediated cardiac remodeling in primary aldosteronism remains incompletely understood. METHODS: We conducted a retrospective study of 547 patients with primary aldosteronism, including 249 men and 298 women. Clinical and echocardiographic data were collected at baseline and 1 year following aldosterone-targeted therapies. RESULTS: The mean age was 53.8 years in men and 54.6 years in women. At baseline, men had a higher left ventricular mass index (LVMI), whereas women had a higher prevalence of left ventricular (LV) hypertrophy and worse diastolic function, as indicated by a higher ratio of early diastolic transmitral to mitral annular velocity (E/e′) and left atrial volume index. In multivariable analyses, plasma aldosterone concentration was associated with baseline LVMI in both sexes. Associations between plasma aldosterone concentration and baseline diastolic indices, including E/e′ and left atrial volume index, were observed in men but not in women in sex-stratified models. However, formal interaction testing did not demonstrate significant sex-by- plasma aldosterone concentration interactions for left atrial volume index, E/e′, or LAVI. After 1 year of treatment, LVMI reduction was comparable between sexes. Improvement in E/e′ was significantly less pronounced in women. LAVI decreased significantly in men but not in women, although between-sex differences in change were not statistically significant. CONCLUSIONS: Sex-specific differences in cardiac remodeling and diastolic function were observed in patients with primary aldosteronism. Despite lower baseline LVMI, women exhibited a more adverse cardiac phenotype, with a higher prevalence of left ventricular hypertrophy and worse diastolic function. Following aldosterone-targeted therapies, structural regression was similar between sexes, whereas diastolic function improved to a lesser extent in women.
No takes yet. Share an insight, caveat, or question.
Chang et al. (2026) studied this question. Women with primary aldosteronism exhibited worse baseline diastolic function and more left ventricular hypertrophy, and experienced less diastolic improvement after treatment than men.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: