title: Alterations in vascular function in primary aldosteronism: a cardiovascular magnetic resonance imaging study.
abstract: Excess aldosterone is associated with increased cardiovascular risk. Aldosterone has a permissive effect on vascular fibrosis. Cardiovascular magnetic resonance imaging (CMR) allows study of vascular function by measuring aortic distensibility. We compared aortic distensibility in primary aldosteronism (PA), essential hypertension (EH) and normal controls and explored the relationship between aortic distensibility and pulse wave velocity (PWV). We studied PA (n=14) and EH (n=33) subjects and age-matched healthy controls (n=17) with CMR, including measurement of aortic distensibility, and measured PWV using applanation tonometry. At recruitment, PA and EH patients had similar blood pressure and left ventricular mass. Subjects with PA had significantly lower aortic distensibility and higher PWV compared with EH and healthy controls. These changes were independent of other factors associated with reduced aortic distensibility, including ageing. There was a significant relationship between increasing aortic stiffness and age in keeping with physical and vascular ageing. As expected, aortic distensibility and PWV were closely correlated. These results demonstrate that PA patients display increased arterial stiffness compared with EH, independent of vascular ageing. The implication is that aldosterone invokes functional impairment of arterial function. The long-term implications of arterial stiffening in aldosterone excess require further study.
authors.affiliation: BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK.
authors.forename: P B
authors.initials: PB
authors.lastname: Mark
authors.affiliation: BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK.
authors.forename: S
authors.initials: S
authors.lastname: Boyle
authors.affiliation: UniversitätsSpital Zürich, Klinik und Poliklinik für Inner Medizin, Zürich, Switzerland.
authors.forename: L U
authors.initials: LU
authors.lastname: Zimmerli
authors.affiliation: BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK.
authors.forename: E P
authors.initials: EP
authors.lastname: McQuarrie
authors.affiliation: BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK.
authors.forename: C
authors.initials: C
authors.lastname: Delles
authors.affiliation: BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK.
authors.forename: E M
authors.initials: EM
authors.lastname: Freel
mesh_terms: D000367:Age Factors; D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure; D016022:Case-Control Studies; D003187:Compliance; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications*; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D063177:Pulse Wave Analysis; D012307:Risk Factors; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D059289:Vascular Stiffness; D016277:Ventricular Function, Left