ASSOCIATION OF ARTERIAL STIFFNESS WITH CARDIORENAL INJURY IN CHINESE PATIENTS WITH NEWLY-CONFIRMED PRIMARY ALDOSTERONISM: A CROSS-SECTION STUDY

Abstract

Objective: Although the significant associations between arterial stiffness and target organ damage (TOD) have been established in essential hypertension, the evidence on the relationship in newly diagnosed primary aldosteronism (PA) are still limited. The present study aimed to investigate the association of arterial stiffness and TOD in Chinese newly confirmed PA patients. Design and method: Included were 823 newly diagnosed PA patients receiving the extremity blood pressure monitoring from January 2016 to December 2021 at the Fuwai Hospital. Spearman correlation analysis was performed to assess the correlation of vascular stiffing parameters with left ventricular mass index (LVMI), estimated glomerular filtration rate (eGFR) and 24 h urinary albumin to creatinine ratio (UACR). The least absolute shrinkage and selection operator (LASSO) regression model were conducted to select the potential influencing factors, and the univariate and multivariate logistic analysis were used to identify the potential risk factors. Results: The mean age of included patients (female 43.4%) was 51.24 years, and the proportion of TOD was 78.13% (643/823). Compared with PA patients without TOD, those with TOD were older in age, had higher systolic blood pressure, diastolic blood pressure, brachial-ankle pulse wave velocity (BaPWV), UACR and LVMI, and lower eGFR. BaPWV was positively correlated with LVMI (r=0.20, P<0.001) and UACR (r=0.27, P<0.001) but inversely correlated with eGFR (r=0.29,P<0.001). Multivariate adjusted logistic analysis suggested that BaPWV was markedly associated with TOD (odds ratio [OR] =1.134; 95% confidence interval [CI]: 1.055-1.220; P=0.001), left ventricular hypertrophy (LVH) (OR=1.069, 95%CI: 1.011-1.131; P=0.019) and renal injury (OR=1.100, 95%CI: 1.039-1.165; P=0.001). Conclusions: BaPWV was significantly associated with TOD, LVH and renal injury in Chinese newly confirmed PA patients. The present study emphasized the important role of BaPWV in early recognition of TOD in newly confirmed PA patients, which may improve the clinical outcomes via early intervention.