Shi-Min Li MD, Jia-Yi Huang MD, Ching-Yan Zhu MD, Ming-Yen Ng MD, Qing-Shan Lin MD, Min Wu MD, Ming-Ya Liu MD, PhD, Run Wang MD, Gao-Zhen Cao MD, Cong Chen MD, PhD, Mei-Zhen Wu MD, PhD, Qing-Wen Ren MD, Hung-Fat Tse MD, PhD, Kai-Hang Yiu MD, PhD
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引用次数: 0
Abstract
An increased risk of target organ damage (TOD) has been reported in patients with primary aldosteronism (PA). However, there is relatively little related research on the correlation between the degree of TOD and those with and without PA in newly diagnosed hypertensive patients. The aim of this study was to assess the association between PA and TOD among patients with newly diagnosed hypertension. Newly diagnosed hypertensive patients were consecutively recruited from January 2015 to June 2020 at the University of Hong Kong-Shenzhen Hospital. Patients were stratified into those with and without PA. Data for left ventricular mass index (LVMI), carotid intima-media thickness (CIMT) and plaque, and microalbuminuria were systematically collected. A total of 1044 patients with newly diagnosed hypertension were recruited, 57 (5.5%) of whom were diagnosed with PA. Patients with PA had lower blood pressure, serum lipids, body mass index, and plasma renin activity and a higher incidence of hypokalemia than those without PA. In contrast, the prevalence of left ventricular hypertrophy, increased CIMT, and microalbuminuria was higher in patients with PA than in those without PA. Multivariable regression analysis demonstrated that PA was independently associated with increased LVMI, CIMT and microalbuminuria. Among patients with newly diagnosed hypertension, those with PA had more severe TOD, including a higher LVMI, CIMT and microalbuminuria, than those without PA. These findings emphasize the need for screening TOD in newly diagnosed hypertension due to underlying PA.
据报道,原发性醛固酮增多症(PA)患者发生靶器官损害(TOD)的风险增加。然而,对于新诊断的高血压患者的 TOD 程度与有无 PA 患者之间的相关性,相关研究相对较少。本研究旨在评估新诊断的高血压患者中 PA 与 TOD 之间的关联。研究人员于2015年1月至2020年6月期间在香港大学深圳医院连续招募新诊断的高血压患者。患者分为有 PA 和无 PA 两类。系统收集了左心室质量指数(LVMI)、颈动脉内膜中层厚度(CIMT)和斑块以及微量白蛋白尿的数据。共招募了 1044 名新确诊的高血压患者,其中 57 人(5.5%)被确诊为 PA 患者。与非 PA 患者相比,PA 患者的血压、血清脂质、体重指数和血浆肾素活性较低,低钾血症的发生率较高。相比之下,PA 患者的左心室肥大、CIMT 增高和微量白蛋白尿发生率高于非 PA 患者。多变量回归分析表明,PA 与 LVMI、CIMT 和微量白蛋白尿的增加有独立关联。在新诊断的高血压患者中,有 PA 的患者比没有 PA 的患者有更严重的 TOD,包括更高的 LVMI、CIMT 和微量白蛋白尿。这些发现强调了对因潜在 PA 而新诊断的高血压患者进行 TOD 筛查的必要性。
期刊介绍:
The Journal of Clinical Hypertension is a peer-reviewed, monthly publication that serves internists, cardiologists, nephrologists, endocrinologists, hypertension specialists, primary care practitioners, pharmacists and all professionals interested in hypertension by providing objective, up-to-date information and practical recommendations on the full range of clinical aspects of hypertension. Commentaries and columns by experts in the field provide further insights into our original research articles as well as on major articles published elsewhere. Major guidelines for the management of hypertension are also an important feature of the Journal. Through its partnership with the World Hypertension League, JCH will include a new focus on hypertension and public health, including major policy issues, that features research and reviews related to disease characteristics and management at the population level.