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

Introduction: Experimental evidence suggested thataldosterone can cause myocardial hypertrophy and fibrosis.However, previous studies on the association betweenplasma aldosterone concentration (PAC) and left ventricular(LV) mass (LVM) and geometry, in subjects withoutprimary aldosteronism yielded conflicting results.Aim: To evaluate the relationships of PAC with LV massand geometry in patients with essential hypertension (EH),and to assess the influence of gender on theserelationships.Methods: We enrolled 478 subjects (men: 63%; mean age44 ± 12 years) with untreated EH. The measurementsincluded 24-h blood pressures, plasma renin activity (PRA)and PAC, obtained by radioimmunoassay and an echocardiogram.For its skewed distribution PAC was log transformedand expressed as median value and interquartilerange.Results: PAC was significantly lower in subjects withnormal LVM indexed for body surface area (BSA), ascompared to those with concentric remodeling to thepatients with eccentric LV hypertrophy (LVH), and to thesubjects with concentric LVH (Figure 4). Significant correlationsof 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 weresimilar in men and in women and remained statisticallysignificant in multiple regression analyses, even afteradjustment forpotential confounding factors (all p.01).Conclusions: Our results seem to suggest that in essentialhypertensive patients circulating aldosterone levels areindependently associated with concentric LV geometry,without gender related differences.