title: Primary aldosteronism and essential hypertension: assessment of cardiovascular risk at diagnosis and after treatment.
abstract: OBJECTIVE
  Primary aldosteronism (PA), the most frequent form of secondary hypertension, is characterized by a higher rate of cardiovascular (CV) events than essential hypertension (EH). Aim of the study was to evaluate the cardiovascular risk according to the ESH/ESC 2007 guidelines, in patients with PA and with EH, at diagnosis and after treatment.
  
  
  RESULTS
  We prospectively studied 102 PA patients (40 with aldosterone producing adenoma-APA and 62 with idiopathic hyperaldosteronism-IHA) and 132 essential hypertensives at basal and after surgical or medical treatment (mean follow-up period 44 months for PA and 42 months for EH). At baseline evaluation the stratification of CV risk was significantly different: the predominant risk category was the high CV risk (50% in total PA, 53% in PA matched for blood pressure values and 55% in EH), but the very high risk category was twice in PA than in EH patients (36% in total PA and 33% in matched PA vs. 17% in EH, p < 0.05). The worse risk profile of PA was due to a higher prevalence of glycemic alterations, metabolic syndrome and left ventricular hypertrophy (LVH) (p < 0.05). After adequate treatment, the CV risk was significantly reduced becoming comparable in PA and in EH patient due to a reduction of hypertension grading, prevalence of metabolic syndrome, hypertension persistence and LVH (p < 0.05).
  
  
  CONCLUSIONS
  Patients with PA present a high CV risk, which is in part reversible after specific treatment, due both to the reduced blood pressure values and to the improvement of end-organ damage.
authors.affiliation: Division of Endocrinology, Università Politecnica delle Marche, Ospedali Riuniti "Umberto I-G.M. Lancisi-G.Salesi", Via Conca 71, Ancona 60126, Italy; Department of Diabetology and Endocrinology, Asur Marche Area Vasta 1, S. Maria della Misericordia Hospital, Urbino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Turchi
authors.affiliation: Division of Endocrinology, Università Politecnica delle Marche, Ospedali Riuniti "Umberto I-G.M. Lancisi-G.Salesi", Via Conca 71, Ancona 60126, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Ronconi
authors.affiliation: Division of Endocrinology, Università Politecnica delle Marche, Ospedali Riuniti "Umberto I-G.M. Lancisi-G.Salesi", Via Conca 71, Ancona 60126, Italy.
authors.forename: V
authors.initials: V
authors.lastname: di Tizio
authors.affiliation: Division of Endocrinology, Università Politecnica delle Marche, Ospedali Riuniti "Umberto I-G.M. Lancisi-G.Salesi", Via Conca 71, Ancona 60126, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Ceccoli
authors.affiliation: Division of Endocrinology, Università Politecnica delle Marche, Ospedali Riuniti "Umberto I-G.M. Lancisi-G.Salesi", Via Conca 71, Ancona 60126, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Boscaro
authors.affiliation: Division of Endocrinology, Università Politecnica delle Marche, Ospedali Riuniti "Umberto I-G.M. Lancisi-G.Salesi", Via Conca 71, Ancona 60126, Italy. Electronic address: g.giacchetti@ospedaliriuniti.marche.it.
authors.forename: G
authors.initials: G
authors.lastname: Giacchetti
mesh_terms: D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D000075222:Essential Hypertension; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000453:epidemiology*; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D000450:Aldosterone
keywords: Adrenal gland; Cardiovascular risk; Primary aldosteronism