title: Circulating aldosterone and mortality in female nursing home residents.
abstract: OBJECTIVE
  To date studies evaluating the relation between circulating aldosterone levels and mortality in elderly female individuals are lacking. We therefore aimed to assess the relationship between circulating aldosterone levels and mortality in a population-based cohort study of female nursing home residents.
  
  
  METHODS
  Individuals aged 70years and older were recruited from 95 nursing homes in Austria. Participants were enrolled and followed up by mobile study teams. All participants underwent an extensive health examination and were followed until death or end of the study. Serum aldosterone concentration (SAC) was measured at baseline after exclusion of twenty seven patients taking mineralocorticoid-receptor (MR) blockers.
  
  
  RESULTS
  Median SAC was 171.1 (IQR: 103.2-303.4) pg/mL (normal range: 30-400) in 471 female individuals (mean age: 83.7±6.2years). After a median follow-up of 27±8months, a total of 121 (25.7%) participants died. In multivariable Cox proportional hazard analysis, SAC levels stratified in quartiles were significantly associated with all-cause mortality. Compared with the reference (first) SAC quartile, the Cox proportional hazard ratio (confidence interval 95%) for the fourth SAC quartiles was 1.94, 95% CI=1.08-3.46, p=0.026. We found statistically significant interaction terms between SAC-related mortality and the presence of advanced heart failure (NYHA functional class III; p=0.038), HbA1c (p=0.043) and eGFR levels (p=0.030).
  
  
  CONCLUSIONS
  Higher circulating aldosterone levels are related to an increased mortality risk in elderly female nursing home residents. Interventional studies are needed to assess the potential influence of MR blockade on "hard" clinical outcomes in individuals aged 70years and older.
authors: Department of Cardiology, Medical University of Graz, Graz, Austria. andreas.tomaschitz@gmx.at
authors: Andreas
authors: A
authors: Tomaschitz
authors: Stefan
authors: S
authors: Pilz
authors: Burkert
authors: B
authors: Pieske
authors: Eberhard
authors: E
authors: Ritz
authors: Winfried
authors: W
authors: März
authors: Andreas
authors: A
authors: Meinitzer
authors: Harald
authors: H
authors: Dobnig
authors: Karin
authors: K
authors: Amrein
authors: Katharina
authors: K
authors: Kienreich
authors: Nicolas
authors: N
authors: Verheyen
authors: Elisabeth
authors: E
authors: Kraigher-Krainer
authors: Christiane
authors: C
authors: Drechsler
authors: Caterina
authors: C
authors: Colantonio
authors: Doris
authors: D
authors: Wagner
authors: Astrid
authors: A
authors: Fahrleitner-Pammer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood*; D001317:Austria / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006333:Heart Failure / Q000097:blood / Q000401:mortality; D006707:Homes for the Aged; D006801:Humans; D009026:Mortality; D009735:Nursing Homes; D011446:Prospective Studies
chemical_list: D000450:Aldosterone; D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human