Association between aldosterone and the risk of cardiovascular disease in hypertensive patients: a cohort study.

OBJECTIVE

Whether plasma aldosterone concentration (PAC) is associated with incident cardiovascular disease (CVD) remains unclear in hypertensive patients, particularly after excluding those with primary aldosteronism. This study evaluates the association between PAC and incident CVD.

METHODS

This study included hypertensive patients admitted to the hypertension center between January 1, 2014, and December 31, 2017, who had PAC measurements. Incident events encompassed both cardiac events and stroke. Cox proportional hazards models were used to evaluate the association between PAC and the outcome.

RESULTS

A total of 8653 hypertensive patients were included in this study. During a median follow-up of 5.2 years, 737 cases of incident CVD occurred. The incidence of the outcome increased with higher quartiles of PAC. Individuals in the highest quartile of PAC had a 51% increased risk of CVD (HR 1.51, 95% CI 1.23-1.86) compared to those in the lowest quartile. The overall results remained stable and consistent in the stratification and sensitivity analyses.

CONCLUSIONS

Higher PAC was associated with increased risk of CVD in hypertensive patients, irrespective of concomitant primary aldosteronism. These findings suggest that PAC might be a target for early prevention.