Ps-c22-1: difference in aldosterone dependency between cardiovascular diseases and renal impairments in patients with primary aldosteronism

Recently, we assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalences of CVD (stroke, ischemic heart disease, and heart failure), cardiomegaly (left ventricular mass index: LVMI) and renal impairment (proteinuria and lowered eGFR) among patients with PA and those with essential hypertension (EHT). We also performed logistic regression analysis to determine which parameters significantly increased the odds ratio for these complications. As the results, the prevalence of CVD was significantly higher among patients with PA than among matched patients with EHT. The prevalence of proteinuria was also significantly higher among PA than EHT patients, whereas there was no significant difference in the prevalence of lowered eGFR. Multivariable logistic regression analysis showed that the PAC was not linearly related to the adjusted odds ratio for CVD and cardiomegaly though the PAC after saline infusion test and captopril challenge test was positively related to LVMI. By contrast, regarding renal complications, the PAC significantly increases the adjusted odds ratios for proteinuria and lowered eGFR independent of other known risk factors. The mechanism underlying the kidney damage in patients with PA may thus differ from that affecting the cardiovascular system.