Prevalence of Cardiovascular Disease and Its Risk Factors in Primary Aldosteronism A Multicenter Study in Japan

Nagahama Study*; JPAS Study Group

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) in patients with primary aldosteronism (PA); however, their results have left it unclear whether CVD is affected by the plasma aldosterone concentration or hypokalemia. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalence of CVD among patients with PA with that among age-, sex-, and blood pressure-matched essential hypertension patients and participants with hypertension in a general population cohort. We also performed binary logistic regression analysis to determine which parameters significantly increased the odds ratio for CVD. Of the 2582 patients with PA studied, the prevalence of CVD, including stroke (cerebral infarction, cerebral hemorrhage, or subarachnoid hemorrhage), ischemic heart disease (myocardial infarction or angina pectoris), and heart failure, was 9.4% (stroke, 7.4%; ischemic heart disease, 2.1%; and heart failure, 0.6%). The prevalence of CVD, especially stroke, was higher among the patients with PA than those with essential hypertension/ hypertension. Hypokalemia (K+ ≤3.5 mEq/L) and the unilateral subtype significantly increased adjusted odds ratios for CVD. Although aldosterone levels were not linearly related to the adjusted odds ratio for CVD, patients with plasma aldosterone concentrations ≥125 pg/mL had significantly higher adjusted odds ratios for CVD than those with plasma aldosterone concentrations <125 pg/mL. Thus, patients with PA seem to be at a higher risk of developing CVD than patients with essential hypertension. Moreover, patients with PA presenting with hypokalemia, the unilateral subtype, or plasma aldosterone concentration ≥125 pg/mL are at a greater risk of CVD and have a greater need for PA-specific treatments than others.

Original languageEnglish
Pages (from-to)530-537
Number of pages8
JournalHypertension
Volume71
Issue number3
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Hyperaldosteronism
Multicenter Studies
Japan
Cardiovascular Diseases
Aldosterone
Hypokalemia
Odds Ratio
Stroke
Myocardial Ischemia
Heart Failure
Hypertension
Cerebral Infarction
Cerebral Hemorrhage
Angina Pectoris
Subarachnoid Hemorrhage
Cross-Sectional Studies
Logistic Models
Myocardial Infarction
Regression Analysis
Databases

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Prevalence of Cardiovascular Disease and Its Risk Factors in Primary Aldosteronism A Multicenter Study in Japan. / Nagahama Study*; JPAS Study Group.

In: Hypertension, Vol. 71, No. 3, 01.01.2018, p. 530-537.

Research output: Contribution to journalArticle

@article{cc4f310829f7483695b543e2cff94e08,
title = "Prevalence of Cardiovascular Disease and Its Risk Factors in Primary Aldosteronism A Multicenter Study in Japan",
abstract = "There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) in patients with primary aldosteronism (PA); however, their results have left it unclear whether CVD is affected by the plasma aldosterone concentration or hypokalemia. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalence of CVD among patients with PA with that among age-, sex-, and blood pressure-matched essential hypertension patients and participants with hypertension in a general population cohort. We also performed binary logistic regression analysis to determine which parameters significantly increased the odds ratio for CVD. Of the 2582 patients with PA studied, the prevalence of CVD, including stroke (cerebral infarction, cerebral hemorrhage, or subarachnoid hemorrhage), ischemic heart disease (myocardial infarction or angina pectoris), and heart failure, was 9.4{\%} (stroke, 7.4{\%}; ischemic heart disease, 2.1{\%}; and heart failure, 0.6{\%}). The prevalence of CVD, especially stroke, was higher among the patients with PA than those with essential hypertension/ hypertension. Hypokalemia (K+ ≤3.5 mEq/L) and the unilateral subtype significantly increased adjusted odds ratios for CVD. Although aldosterone levels were not linearly related to the adjusted odds ratio for CVD, patients with plasma aldosterone concentrations ≥125 pg/mL had significantly higher adjusted odds ratios for CVD than those with plasma aldosterone concentrations <125 pg/mL. Thus, patients with PA seem to be at a higher risk of developing CVD than patients with essential hypertension. Moreover, patients with PA presenting with hypokalemia, the unilateral subtype, or plasma aldosterone concentration ≥125 pg/mL are at a greater risk of CVD and have a greater need for PA-specific treatments than others.",
author = "{Nagahama Study*; JPAS Study Group} and Youichi Ohno and Masakatsu Sone and Nobuya Inagaki and Toshinari Yamasaki and Osamu Ogawa and Yoshiyu Takeda and Isao Kurihara and Hiroshi Itoh and Hironobu Umakoshi and Mika Tsuiki and Takamasa Ichijo and Takuyuki Katabami and Yasushi Tanaka and Norio Wada and Yui Shibayama and Takanobu Yoshimoto and Yoshihiro Ogawa and Junji Kawashima and Katsutoshi Takahashi and Megumi Fujita and Minemori Watanabe and Yuichi Matsuda and Hiroki Kobayashi and Hirotaka Shibata and Kohei Kamemura and Michio Otsuki and Yuichi Fujii and Koichi Yamamoto and Atsushi Ogo and Shintaro Okamura and Shozo Miyauchi and Tomikazu Fukuoka and Shoichiro Izawa and Takashi Yoneda and Shigeatsu Hashimoto and Toshihiko Yanase and Tomoko Suzuki and Takashi Kawamura and Yasuharu Tabara and Fumihiko Matsuda and Mitsuhide Naruse",
year = "2018",
month = "1",
day = "1",
doi = "10.1161/HYPERTENSIONAHA.117.10263",
language = "English",
volume = "71",
pages = "530--537",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Prevalence of Cardiovascular Disease and Its Risk Factors in Primary Aldosteronism A Multicenter Study in Japan

AU - Nagahama Study; JPAS Study Group

AU - Ohno, Youichi

AU - Sone, Masakatsu

AU - Inagaki, Nobuya

AU - Yamasaki, Toshinari

AU - Ogawa, Osamu

AU - Takeda, Yoshiyu

AU - Kurihara, Isao

AU - Itoh, Hiroshi

AU - Umakoshi, Hironobu

AU - Tsuiki, Mika

AU - Ichijo, Takamasa

AU - Katabami, Takuyuki

AU - Tanaka, Yasushi

AU - Wada, Norio

AU - Shibayama, Yui

AU - Yoshimoto, Takanobu

AU - Ogawa, Yoshihiro

AU - Kawashima, Junji

AU - Takahashi, Katsutoshi

AU - Fujita, Megumi

AU - Watanabe, Minemori

AU - Matsuda, Yuichi

AU - Kobayashi, Hiroki

AU - Shibata, Hirotaka

AU - Kamemura, Kohei

AU - Otsuki, Michio

AU - Fujii, Yuichi

AU - Yamamoto, Koichi

AU - Ogo, Atsushi

AU - Okamura, Shintaro

AU - Miyauchi, Shozo

AU - Fukuoka, Tomikazu

AU - Izawa, Shoichiro

AU - Yoneda, Takashi

AU - Hashimoto, Shigeatsu

AU - Yanase, Toshihiko

AU - Suzuki, Tomoko

AU - Kawamura, Takashi

AU - Tabara, Yasuharu

AU - Matsuda, Fumihiko

AU - Naruse, Mitsuhide

PY - 2018/1/1

Y1 - 2018/1/1

N2 - There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) in patients with primary aldosteronism (PA); however, their results have left it unclear whether CVD is affected by the plasma aldosterone concentration or hypokalemia. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalence of CVD among patients with PA with that among age-, sex-, and blood pressure-matched essential hypertension patients and participants with hypertension in a general population cohort. We also performed binary logistic regression analysis to determine which parameters significantly increased the odds ratio for CVD. Of the 2582 patients with PA studied, the prevalence of CVD, including stroke (cerebral infarction, cerebral hemorrhage, or subarachnoid hemorrhage), ischemic heart disease (myocardial infarction or angina pectoris), and heart failure, was 9.4% (stroke, 7.4%; ischemic heart disease, 2.1%; and heart failure, 0.6%). The prevalence of CVD, especially stroke, was higher among the patients with PA than those with essential hypertension/ hypertension. Hypokalemia (K+ ≤3.5 mEq/L) and the unilateral subtype significantly increased adjusted odds ratios for CVD. Although aldosterone levels were not linearly related to the adjusted odds ratio for CVD, patients with plasma aldosterone concentrations ≥125 pg/mL had significantly higher adjusted odds ratios for CVD than those with plasma aldosterone concentrations <125 pg/mL. Thus, patients with PA seem to be at a higher risk of developing CVD than patients with essential hypertension. Moreover, patients with PA presenting with hypokalemia, the unilateral subtype, or plasma aldosterone concentration ≥125 pg/mL are at a greater risk of CVD and have a greater need for PA-specific treatments than others.

AB - There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) in patients with primary aldosteronism (PA); however, their results have left it unclear whether CVD is affected by the plasma aldosterone concentration or hypokalemia. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalence of CVD among patients with PA with that among age-, sex-, and blood pressure-matched essential hypertension patients and participants with hypertension in a general population cohort. We also performed binary logistic regression analysis to determine which parameters significantly increased the odds ratio for CVD. Of the 2582 patients with PA studied, the prevalence of CVD, including stroke (cerebral infarction, cerebral hemorrhage, or subarachnoid hemorrhage), ischemic heart disease (myocardial infarction or angina pectoris), and heart failure, was 9.4% (stroke, 7.4%; ischemic heart disease, 2.1%; and heart failure, 0.6%). The prevalence of CVD, especially stroke, was higher among the patients with PA than those with essential hypertension/ hypertension. Hypokalemia (K+ ≤3.5 mEq/L) and the unilateral subtype significantly increased adjusted odds ratios for CVD. Although aldosterone levels were not linearly related to the adjusted odds ratio for CVD, patients with plasma aldosterone concentrations ≥125 pg/mL had significantly higher adjusted odds ratios for CVD than those with plasma aldosterone concentrations <125 pg/mL. Thus, patients with PA seem to be at a higher risk of developing CVD than patients with essential hypertension. Moreover, patients with PA presenting with hypokalemia, the unilateral subtype, or plasma aldosterone concentration ≥125 pg/mL are at a greater risk of CVD and have a greater need for PA-specific treatments than others.

UR - http://www.scopus.com/inward/record.url?scp=85047812621&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047812621&partnerID=8YFLogxK

U2 - 10.1161/HYPERTENSIONAHA.117.10263

DO - 10.1161/HYPERTENSIONAHA.117.10263

M3 - Article

C2 - 29358460

AN - SCOPUS:85047812621

VL - 71

SP - 530

EP - 537

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 3

ER -