title: Observational study mortality in treated primary aldosteronism: the German Conn's registry.
abstract: In comparison with essential hypertension, primary aldosteronism (PA) is associated with an increased risk of cardiovascular morbidity. To date, no data on mortality have been published. We assessed mortality of patients treated for PA within the German Conn's registry and identified risk factors for adverse outcome in a case-control study. Patients with confirmed PA treated in 3 university centers in Germany since 1994 were included in the analysis. All of the patients were contacted in 2009 and 2010 to verify life status. Subjects from the population-based F3 survey of the Cooperative Health Research in the Region of Augsburg served as controls. Final analyses were based on 600 normotensive controls, 600 hypertensive controls, and 300 patients with PA. Kaplan-Meyer survival curves were calculated for both cohorts. Ten-year overall survival was 95% in normotensive controls, 90% in hypertensive controls, and 90% in patients with PA (P value not significant). In multivariate analysis, age (hazard ratio, 1.09 per year [95% CI, 1.03-1.14]), angina pectoris (hazard ratio, 3.6 [95% CI, 1.04-12.04]), and diabetes mellitus (hazard ratio, 2.55 [95% CI, 1.07-6.09]) were associated with an increase in all-cause mortality, whereas hypokalemia (hazard ratio, 0.41 per mmol/L [95% CI, 0.17-0.99]) was associated with reduced mortality. Cardiovascular mortality was the main cause of death in PA (50% versus 34% in hypertensive controls; P<0.05). These data indicate that cardiovascular mortality is increased in patients treated for PA, whereas all-cause mortality is not different from matched hypertensive controls.
authors: Medizinische Klinik und Poliklinik IV, Campus Innnestadt, Klinikum der Universität München, Ziemssenstr 1, 80336 München, Germany. martin.reincke@med.uni-muenchen.de
authors: Martin
authors: M
authors: Reincke
authors: Evelyn
authors: E
authors: Fischer
authors: Sabine
authors: S
authors: Gerum
authors: Katrin
authors: K
authors: Merkle
authors: Sebastian
authors: S
authors: Schulz
authors: Anna
authors: A
authors: Pallauf
authors: Marcus
authors: M
authors: Quinkler
authors: Gregor
authors: G
authors: Hanslik
authors: Katharina
authors: K
authors: Lang
authors: Stefanie
authors: S
authors: Hahner
authors: Bruno
authors: B
authors: Allolio
authors: Christa
authors: C
authors: Meisinger
authors: Rolf
authors: R
authors: Holle
authors: Felix
authors: F
authors: Beuschlein
authors: Martin
authors: M
authors: Bidlingmaier
authors: Stephan
authors: S
authors: Endres
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006929:Hyperaldosteronism / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors