ECEESPE2025 Rapid Communications Rapid Communications 1: Adrenal and Cardiovascular Endocrinology (5 abstracts)
Clinical and biochemical determinants of left ventricular hypertrophy and its severity in primary aldosteronism: insights from the SPAIN-ALDO registry
Arturo Vega-Beyhart 1 , Jorge Gabriel Ruiz Sánchez 2 , Patricia Martin Rojas 3 , Miguel Paja 4 , Elena Mena Ribas 5 , Margarita González Boillos 6 , Almudena Vicente 7 , Eider Pascual-Corrales 1 , Carolina M. Perdomo 8 , María Calatayud 9 , Alicia Sanmartín Sánchez 5 , Laura Caja-Guayerbas 1 , Emilia Gomez Hoyos 10 , Cristina Robles Lázaro 11 , Fernando Jaén-Aguila 12 , Felicia A Hanzu 13 , Patricia Diaz Guardiola 14 , María José Picón César 15 , Laura Manjon Miguelez 16 , Sónsoles Gutierrez-Medina 17 , Albert Puig-Perez 18 , Ángel Rebollo-Román 19 , Miguel Antonio Sampedro Núñez 20 , Monica Recasens 21 , Rebeca Barahona San Millan 21 , Cristina Lamas 22 , Joaquin Serrano 23 , Paola Parra Ramírez 3 & Marta Araujo-Castro 1
1Hospital Universitario Ramón y Cajal, Endocrinology and Nutrition, Madrid, Spain; 2Hospital Fundación Jimenez Diaz, Madrid, Spain; 3Hospital Universitario La Paz, Madrid, Spain; 4Hospital Universitario de Basurto, Bilbao, Spain; 5Hospital Universitario Son Espases, Islas Baleares, Spain; 6Hospital Universitario de Castellón, Castellón, Spain; 7Hospital Universitario de Toledo, Toledo, Spain; 8Clínica Universidad de Navarra, Pamplona, Spain; 9Hospital Doce de Octubre, Madrid, Spain; 10Hospital Universitario de Valladolid, Valladolid, Spain; 11Hospital Clínico Universitario de Salamanca, Salamanca, Spain; 12Hospital Universitario Virgen de las Nieves, Granada, Spain; 13Hospital Clinic, Barcelona, Spain; 14Hospital Universitario Infanta Sofía, Madrid, Spain; 15Hospital Universitario Virgen de la Victoria de Málaga, Málaga, Spain; 16Hospital Universitario Central de Asturias, Oviedo, Spain; 17Clínica Universidad de Navarra, Madrid, Spain; 18Hospital Universitario Vall D’Hebron, Barcelona, Spain; 19Hospital Reina Sofía, Córdoba, Spain; 20Hospital Universitario La Princesa, Madrid, Spain; 21Hospital De Girona Doctor Josep Trueta, Girona, Spain; 22Complejo Hospitalario Universitario de Albacete, Albacete, Spain; 23Hospital General Universitario de Alicante, Alicante, Spain
JOINT2377
Introduction: Primary aldosteronism (PA) is the leading cause of secondary hypertension, strongly linked to left ventricular hypertrophy (LVH) and systolic dysfunction. Compared to essential hypertension, PA results in worse cardiac remodeling. However, data on factors influencing LVH at PA diagnosis remain scarce.
Methods: SPAIN-ALDO is a multicenter, national registry of patients with PA from 37 Spanish hospitals. This subgroup analysis included patients with an echocardiography within 24 months before or after diagnosis, excluding those who underwent PA surgery. Biochemical and clinical data at diagnosis were analyzed to identify independent factors associated with LVH.
Results: 343 patients were included (women n=119, 35%) with a mean diagnosis age of 56±12 yo. 188 patients (55%) had LVH from which, 108 (57%) had mild LVH severity, 69 (37%) moderate, and 11 (6%) a severe degree. Random forest analysis adjusted for age and sex identified patients with LVH as having longer durations of high blood pressure, a higher basal aldosterone index, higher BMI, elevated serum HbA1c levels, and increased 1mg overnight dexamethasone suppression test (ONDST) cortisol, along with lower glomerular filtration rates. Additionally, they were more likely to be male, active smokers, and have dyslipidemia and hypokalemia (P=0.011, R2=50.2%, Q2=0.73, correctly predicted group: 73.9%). However, only glomerular filtration (OR=0.12 [0.01 – 0.92]), active smoking (OR=15.6 [1.79 – 37.2]), and hypokalemia (OR=6.0 [1.3 – 16.8]) remained independent factors associated with LVH (P=0.001, R2=42.1%). The presence of type 2 diabetes mellitus (DM) was associated with LVH severity, with percentages of DM patients per group being 20%, 36%, and 46% in mild, moderate and severe LVH, respectively (P<0.01). Similarly, hypertensive retinopathy proportion of patients (mild=4%, moderate=17%, severe=27%) and microalbuminuria (mild=23%, moderate=53%, severe=67%) increased with LVH severity (P<0.01). Finally, basal aldosterone levels (ng/dl) increased with LVH severity: mild=19.4 [13.9–31.5], moderate=29.2 [20.7–47.6], severe=27.6 [22.8–47.5] (P=0.005), as did ONDST cortisol levels (µg/d): mild=1.5 [1.17–185], moderate=2.10 [1.51–4.35], severe=3.30 [1.40–4.50] (P=0.014).
Conclusion: Among patients with PA, those with active smoking, lower glomerular filtration and hypokalemia at diagnosis are at higher risk of developing LVH while higher levels of aldosterone and ONDST cortisol are associated with LVH severity.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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