title: Plasma aldosterone and its relationships with left ventricular mass in essential hypertensive patients with the metabolic syndrome.
abstract: 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.
authors.affiliation: 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
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mulè
authors.forename: Emilio
authors.initials: E
authors.lastname: Nardi
authors.forename: Paola
authors.initials: P
authors.lastname: Cusimano
authors.forename: Santina
authors.initials: S
authors.lastname: Cottone
authors.forename: Giovanna
authors.initials: G
authors.lastname: Seddio
authors.forename: Calogero
authors.initials: C
authors.lastname: Geraci
authors.forename: Alessandro
authors.initials: A
authors.lastname: Palermo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Andronico
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cerasola
mesh_terms: 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
chemical_list: D000450:Aldosterone; D012083:Renin