Abstract
Primary aldosteronism is associated with various types of cardiovascular and cerebrovascular damage independently of hypertension. Although chronic hypertension and related cerebral arteriosclerosis are the main risk factors for intracerebral hemorrhage, the effects of aldosteronism remain poorly understood. We enrolled 90 survivors of hypertensive intracerebral hemorrhage, 21 of them with aldosteronism and 69 with essential hypertension as controls in this study. Clinical parameters and neuroimaging markers of cerebral small vessel disease were recorded, and its correlations with aldosteronism were investigated. Our results showed that the aldosteronism group (55.2 ± 9.7 years, male 47.6%) had similar hypertension severity but exhibited a higher cerebral microbleed count (interquartile range) (8.5 [2.0‒25.8] vs 3 [1.0‒6.0], P = 0.005) and higher severity of dilated perivascular space in the basal ganglia (severe perivascular space [number >20], 52.4% vs. 24.6%, P = 0.029; large perivascular space [>3 mm], 52.4% vs. 20.3%, P = 0.010), compared to those with essential hypertension (53.8 ± 11.7 years, male 73.9%). In multivariate models, aldosteronism remained an independent predictor of a higher (>10) microbleed count (odds ratio = 8.60, P = 0.004), severe perivascular space (odds ratio = 4.00, P = 0.038); the aldosterone-to-renin ratio was associated with dilated perivascular space (P = 0.043) and large perivascular space (P = 0.008). In conclusions, survivors of intracerebral hemorrhage with aldosteronism showed a tendency towards more severe hypertensive arteriopathy than the essential hypertension counterparts independently of blood pressure; aldosteronism may contribute to dilated perivascular space around the deep perforating arteries.
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TAIPAI study group
Vin-Cent Wu12, Tai-Shuan Lai12, Shih-Chieh Jeff Chueh12, Shao-Yu Yang12, Kao-Lang Liu12, Chin-Chen Chang12, Bo-Ching Lee12, Shuo-Meng Wang12, Kuo-How Huang12, Po-Chih Lin12, Yen-Hung Lin12, Chi-Sheng Hung12, Lian-Yu Lin12, Shih-Cheng Liao12, Ching-Chu Lu12, Chieh-Kai Chan12, Leay-Kiaw Er13, Ya-Hui Hu13, Che-Hsiung Wu13, Yao-Chou Tsai13, Zheng-Wei Chen14, Chien-Ting Pan14, Che-Wei Liao10, Cheng-Hsuan Tsai15, Yi-Yao Chang16, Chen-Hsun Ho17, Wei-Chieh Huang18, Ying-Ying Chen19
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This work was supported by grants from the National Taiwan University Hospital (Lee BC, 109–004687) and Ministry of Science and Technology of Taiwan (111–2314-B-002–250-MY2).
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B-CL project concept and design, data collection, imaging analysis, data analysis, write up. H-HT project concept and design, imaging analysis. Z-WC project concept and design, critical revisions. C-CC project concept and design. L-KT project concept and design. J-ZH data collection, imaging analysis. Y-YC project concept and design. C-HT project concept and design. C-HC critical revisions. C-WL critical revisions. C-TP critical revisions. C-SH critical revisiśons. V-CW project concept and design, data collection, critical revisions. Y-HL project concept and design, data collection, imaging analysis, critical revisions.
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Lee, BC., Tsai, HH., Chen, ZW. et al. Aldosteronism is associated with more severe cerebral small vessel disease in hypertensive intracerebral hemorrhage. Hypertens Res 47, 608–617 (2024). https://doi.org/10.1038/s41440-023-01458-w
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DOI: https://doi.org/10.1038/s41440-023-01458-w
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