Why the study?
Hypertensive emergency causes multiple organ injuries and activates the RAS, but whether the RAS contributes to the development of this organ damage has not been fully elucidated.
Is higher plasma aldosterone concentration associated with target organ damage in patients with hypertensive emergencies?
Is higher plasma aldosterone concentration associated with target organ damage in patients with hypertensive emergencies?
In patients with hypertensive emergencies, higher plasma aldosterone levels (≥ 250 pg/mL) are strongly associated with the presence of multiple target organ damages.
May signal elevated multiple-organ damage risk; hypothesis-generating for aldosterone-targeted trials in hypertensive emergencies.
BACKGROUND: Hypertensive emergency is a critical disease that causes multiple organ injuries. Although the renin-angiotensin-aldosterone system (RAS) is enormously activated in this disorder, whether the RAS contributes to the development of the organ damage has not been fully elucidated. This cross-sectional study was conducted to characterize the association between RAS and the organ damage in patients with hypertensive emergencies. Then, whether each organ injury was associated with blood pressure or a plasma aldosterone concentration was analyzed. RESULTS: Among 63 patients, 31, 37, 43 and 8 cases manifested SKI, severe retinopathy, c-LVH and ischemic stroke, respectively. All populations with the organ injuries except cerebral infarction had higher plasma aldosterone concentrations than the remaining subset but exhibited a variable difference in systolic or diastolic blood pressure. Twenty-two patients had a triad of SKI, severe retinopathy and c-LVH, among whom 5 patients manifested TMA. Furthermore, the number of the damaged organs was correlated with plasma aldosterone levels (Spearman's coefficient = 0.50), with a strong association observed between plasma aldosterone (≥ 250 pg/mL) and 3 or more complications (odds ratio = 9.16 [95%CI: 2.76-30.35]). CONCLUSION: In patients with hypertensive emergencies, a higher aldosterone level not only contributed to the development of the organ damage but also was associated with the number of damaged organs in each patient.
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Miyake et al. (2024) studied this question.
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