title: Association of Post-Saline Load Plasma Aldosterone Levels With Left Ventricular Hypertrophy in Primary Hypertension.
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH) is an independent risk factor for cardiovascular morbidity in hypertension. Current evidence suggests a contribution to LVH of plasma aldosterone levels that are inappropriately elevated for the salt status. The aim of this study was to investigate whether inappropriate modulation of aldosterone production by a saline load is associated with left ventricular (LV) mass in hypertensive patients.
  
  
  METHODS
  In 90 hypertensive patients free of clinically relevant cardiovascular complications in whom secondary forms of hypertension were ruled out, we performed a standard intravenous saline load (0.9% NaCl, 2 l in 4 hours) with measurement of plasma aldosterone and active renin at baseline and end of infusion. Bi-dimensional echocardiography was performed for the assessment of cardiac morphology and function.
  
  
  RESULTS
  LVH was present in 19% of patients who had significantly worse renal function and higher body mass, blood pressure, and plasma aldosterone levels measured both at baseline and after the saline load than patients without LVH. LV mass was directly related to age, body mass, systolic blood pressure, duration of hypertension, baseline, and post-saline load plasma aldosterone levels and inversely to glomerular filtration. Multivariate regression analysis showed independent correlation of LV mass with body mass, systolic blood pressure, and plasma aldosterone levels measured after intravenous saline load, but not at baseline.
  
  
  CONCLUSIONS
  In patients with hypertension, aldosterone levels measured after intravenous saline load are related to LV mass independent of age, body mass, and blood pressure, suggesting that limited ability of salt to modulate aldosterone production could contribute to LVH.
authors.affiliation: Division of Cardiology, Department of Medicine, Medical University of Graz, Graz, Austria; Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy; cristiana.catena@uniud.it.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Catena
authors.affiliation: Division of Cardiology, Department of Medicine, Medical University of Graz, Graz, Austria;
authors.forename: Nicolas D
authors.initials: ND
authors.lastname: Verheyen
authors.affiliation: Division of Cardiology, Department of Medicine, Medical University of Graz, Graz, Austria;
authors.forename: Marion
authors.initials: M
authors.lastname: Url-Michitsch
authors.affiliation: Department of Internal Medicine and Cardiology, Charitè University Medicine, Campus Virchow Klinikum and German Heart Center, Berlin, Germany;
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kraigher-Krainer
authors.affiliation: Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy;
authors.forename: GianLuca
authors.initials: G
authors.lastname: Colussi
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Pilz
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Tomaschitz
authors.affiliation: Department of Internal Medicine and Cardiology, Charitè University Medicine, Campus Virchow Klinikum and German Heart Center, Berlin, Germany;
authors.forename: Burkert
authors.initials: B
authors.lastname: Pieske
authors.affiliation: Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy;
authors.forename: Leonardo A
authors.initials: LA
authors.lastname: Sechi
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood*; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D007262:Infusions, Intravenous; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012083:Renin / Q000097:blood / Q000187:drug effects*; D012084:Renin-Angiotensin System / Q000187:drug effects; D012965:Sodium Chloride / Q000494:pharmacology*
chemical_list: D012965:Sodium Chloride; D000450:Aldosterone; D012083:Renin
keywords: active renin; aldosterone; blood pressure; echocardiography; hypertension; intravenous saline load; left ventricular hypertrophy; left ventricular mass; salt.