Plasma aldosterone and its relationships with left ventricular mass in essential hypertensive patients with the metabolic syndrome.
BACKGROUND
The association of aldosterone with the metabolic syndrome (MetS) has not been fully elucidated. The aim of our study was to evaluate the relationships of plasma aldosterone concentration (PAC) with MetS and left ventricular mass (LVM) in nondiabetic Caucasian patients with essential hypertension.


METHODS
Measurements were taken with the patients off antihypertensive medications. The measurements included 24-h blood pressure (BP) readings, plasma renin activity (PRA) and aldosterone, and an echocardiogram.


RESULTS
Subjects with MetS (n = 201) had higher age-adjusted PAC (10.2 +/- 5.8 vs. 11.6 +/- 5.9 ng/dl; P = 0.01) and greater age-adjusted LVM indexed for height2.7 (LVMH2.7) (56 +/- 19 vs. 62 +/- 20 g/m2; P = 0.001) than those without MetS (n = 249). The difference in respect of PAC between the two groups was independent of PRA and was attributable mainly to obesity. After adjusting for potential confounders, LVMH2.7 was associated with MetS as a whole (beta = 0.11; P = 0.02) and with body mass index (BMI) (beta = 0.19; P < 0.0001) in the overall population. The latter relationship was attenuated (beta = 0.15; P = 0.001) after further adjustment for PAC. In the MetS group the association of LVMH2.7 with PAC held (beta = 0.19; P = 0.007) in multivariate analyses. In subjects without MetS, this relationship had only borderline statistical significance.


CONCLUSIONS
Our results suggest that the elevated PAC related to obesity may help to explain the increased LVM observed in association with MetS, and may contribute to enhancing the cardiovascular risk associated with MetS.
Mulè
Giuseppe
G
Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Medicina Interna e Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Italy. giusemme@unipa.it
Nardi
Emilio
E
Cusimano
Paola
P
Cottone
Santina
S
Seddio
Giovanna
G
Geraci
Calogero
C
Palermo
Alessandro
A
Andronico
Giuseppe
G
Cerasola
Giovanni
G
D000328:Adult; D000450:Aldosterone / Q000097:blood*; D001794:Blood Pressure; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D012083:Renin / Q000097:blood
D000450:Aldosterone; D012083:Renin