RELATIONSHIPS BETWEEN PLASMA ALDOSTERONE LEVELS AND LEFT VENTRICULAR MASS AND GEOMETRY IN ESSENTIAL HYPERTENSIVE PATIENTS: DOES SEX MATTER?

Introduction: Experimental evidence suggested that aldosterone can cause myocardial hypertrophy and fibrosis. However, previous studies on the association between plasma aldosterone concentration (PAC) and left ventricular (LV) mass (LVM) and geometry, in subjects without primary aldosteronism yielded conflicting results. Aim: To evaluate the relationships of PAC with LV mass and geometry in patients with essential hypertension (EH), and to assess the influence of gender on these relationships. Methods: We enrolled 478 subjects (men: 63%; mean age 44 ± 12 years) with untreated EH. The measurements included 24-h blood pressures, plasma renin activity (PRA) and PAC, obtained by radioimmunoassay and an echocardiogram. For its skewed distribution PAC was log transformed and expressed as median value and interquartile range. Results: PAC was significantly lower in subjects with normal LVM indexed for body surface area (BSA), as compared to those with concentric remodeling to the patients with eccentric LV hypertrophy (LVH), and to the subjects with concentric LVH (Figure 4). Significant correlations of Log (PAC) with LVM, either indexed for BSA (r = 0.20; p.0001), or for height^2.7 (r = 0.21; p.0001) and with relative wall thickness (RWT) (r = 0.18; p.0001) were found. These correlations were similar in men and in women and remained statistically significant in multiple regression analyses, even after adjustment for potential confounding factors (all p.01). Conclusions: Our results seem to suggest that in essential hypertensive patients circulating aldosterone levels are independently associated with concentric LV geometry, without gender related differences.