Prevalence and characteristics of the metabolic syndrome in primary aldosteronism.
BACKGROUND
Patients with hypertension have a high prevalence of concurrent metabolic abnormalities, including obesity, dyslipidemia, and hyperglycemia. Clustering of these cardiovascular risk factors, defined as metabolic syndrome, causes a more pronounced target organ damage. Aldosterone excess has been found to be associated with glucose disorders and may contribute to cardiovascular damage.


OBJECTIVE
The aim of our study was to assess the prevalence and the characteristics of the metabolic syndrome in a group of patients with hypertension due to primary aldosteronism compared with patients with essential hypertension.


METHODS
The National Cholesterol Education Program Adult Treatment Panel III definition of the metabolic syndrome was used. Eighty-five patients with primary aldosteronism and 381 patients with essential hypertension were studied. Most patients were not receiving antihypertensive therapy during the investigation.


RESULTS
Blood glucose and systolic blood pressure were higher (P < 0.05 and P < 0.01, respectively) and duration of hypertension was longer (P < 0.05) in primary aldosteronism than in essential hypertension. The prevalence of metabolic syndrome was higher in primary aldosteronism than in essential hypertension (41.1% vs. 29.6%; P < 0.05). Distribution of single components of the metabolic syndrome other than hypertension showed a higher prevalence of hyperglycemia in primary aldosteronism than in essential hypertension (27.0% vs. 15.2%; P < 0.05).


CONCLUSIONS
Our findings confirm a negative effect of aldosterone excess on glucose metabolism and suggest that the recently reported higher rates of cardiovascular events in primary aldosteronism than in essential hypertension might be due to increased prevalence of the metabolic syndrome in the former condition.
Fallo
Francesco
F
Department of Medical and Surgical Sciences, Universita di Padova, Via Ospedale 105, 35128 Padua, Italy. francesco.fallo@unipd.it
Veglio
Franco
F
Bertello
Chiara
C
Sonino
Nicoletta
N
Della Mea
Paolo
P
Ermani
Mario
M
Rabbia
Franco
F
Federspil
Giovanni
G
Mulatero
Paolo
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000150:complications* / Q000378:metabolism; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000378:metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000378:metabolism; D008875:Middle Aged; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides