Plasma aldosterone concentration and valvular heart disease in hypertensive patients: a large cross-sectional study

Prior research has demonstrated that plasma aldosterone concentration (PAC) is critically involved in cardiovascular disease (CVD). However, investigations specifically focusing on its association with valvular heart disease (VHD) remain limited. To address this gap in knowledge, this study aims to examine the relationship between PAC and VHD in hypertensive patients. The analysis included data from 35,622 hospitalized patients between January 2010 and February 2025. A multivariable logistic regression model was employed to evaluate the main relationship. To refine this relationship, restricted cubic spline (RCS) analysis was performed to investigate dose–response relationships and pinpoint possible inflection points. Additionally, subgroup analysis was performed to evaluate the data’ overall robustness. Logistic regression analysis showed a strong association of VHD with PAC levels. This association was further characterized using RCS, which illustrated a nonlinear dose-response relationship. Notably, the RCS model identified specific saturation points with threshold effects at PAC levels of 14.5 ng/dL, 14.2 ng/dL, and 15.0 ng/dL. The robustness of these findings was confirmed through consistent results in extensive subgroup and sensitivity analyses. This study offers the first proof of a substantial correlation between high PAC levels and VHD in hypertension patients. Large-scale, prospective investigations are necessary to validate these results and elucidate the causal link.