title: Aldosterone Predicts Cardiovascular, Renal, and Metabolic Disease in the General Community: A 4-Year Follow-Up.
abstract: BACKGROUND
  We recently reported that normal aldosterone levels are associated with cardiovascular, renal, and metabolic disease in a sample of the US general community (Visit 1). For the current analyses we used the same cohort in a new 4-year follow-up study (Visit 2).
  
  
  RESULTS
  We measured aldosterone at Visit 1 and analyzed its predictive role for new diseases at Visit 2 (n=1140). We measured aldosterone at Visit 2 and investigated its associations with disease at Visit 2 (n=1368). We analyzed aldosterone continuously and we also dichotomized the variable as whether subjects were in the third tertile versus second and first tertiles. As continuous variable at Visit 1, aldosterone predicted new onset hypertension (HTN) (OR=1.36, CI=1.13-1.63, P=0.001), central obesity (OR=1.36, CI=1.07-1.73, P=0.011), and use of lipid-lowering drugs (OR=1.25, CI=1.05-1.48, P=0.012) at Visit 2, after adjustment for age, sex, and body mass index. When in the third tertile (8.5-88.6 ng/dL), aldosterone predicted type 2 diabetes (T2DM, OR=1.96, CI=1.03-3.70, P=0.039). At Visit 2, aldosterone remained associated with HTN, obesity, and chronic kidney disease (CKD), as reported for Visit 1. However, aldosterone was not associated with heart failure (HF) at Visit 1 and 2, nor was aldosterone a predictor of HF between visits.
  
  
  CONCLUSIONS
  Aldosterone predicts new HTN, central obesity, T2DM, and use of lipid-lowering drugs in the general community and remains associated with HTN, obesity, and CKD over 4 years. Aldosterone is not associated nor predicts HF. Further studies are warranted to evaluate aldosterone as therapeutic target in the general community.
authors.affiliation: Cardiorenal Research Laboratory, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., J.C.B.) Division of Cardiovascular Diseases, Department of Medicine, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., R.J.R., J.C.B.).
authors.forename: Alessia
authors.initials: A
authors.lastname: Buglioni
authors.affiliation: Cardiorenal Research Laboratory, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., J.C.B.) Division of Cardiovascular Diseases, Department of Medicine, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., R.J.R., J.C.B.).
authors.forename: Valentina
authors.initials: V
authors.lastname: Cannone
authors.affiliation: Cardiorenal Research Laboratory, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., J.C.B.) Division of Cardiovascular Diseases, Department of Medicine, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., R.J.R., J.C.B.).
authors.forename: S Jeson
authors.initials: SJ
authors.lastname: Sangaralingham
authors.affiliation: Cardiorenal Research Laboratory, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., J.C.B.) Division of Cardiovascular Diseases, Department of Medicine, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., R.J.R., J.C.B.).
authors.forename: Denise M
authors.initials: DM
authors.lastname: Heublein
authors.affiliation: Department of Health Sciences Research, College of Medicine Mayo Clinic, Rochester, MN (C.G.S., K.R.B.).
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Scott
authors.affiliation: Department of Health Sciences Research, College of Medicine Mayo Clinic, Rochester, MN (C.G.S., K.R.B.).
authors.forename: Kent R
authors.initials: KR
authors.lastname: Bailey
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., R.J.R., J.C.B.).
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Rodeheffer
authors.affiliation: Internal Medicine and Geriatrics and "Hypertension Excellence Centre" of the European Society of Hypertension, Department of Clinical and Molecular Sciences, University "Politecnica delle Marche", Ancon, Italy (R.S.) Italian National Research Centre on Aging "U. Sestilli", IRCCS-INRCA, Ancon, Italy (R.S.).
authors.forename: Riccardo
authors.initials: R
authors.lastname: Sarzani
authors.affiliation: Cardiorenal Research Laboratory, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., J.C.B.) Division of Cardiovascular Diseases, Department of Medicine, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., R.J.R., J.C.B.).
authors.forename: John C
authors.initials: JC
authors.lastname: Burnett
mesh_terms: D000368:Aged; D000450:Aldosterone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy; D006973:Hypertension / Q000097:blood; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000097:blood*; D008297:Male; D056128:Obesity, Abdominal / Q000097:blood; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers; D000960:Hypolipidemic Agents; D000450:Aldosterone
keywords: aldosterone; diabetes mellitus; general community; heart failure; obesity