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Alterations in vascular function in primary aldosteronism: a cardiovascular magnetic resonance imaging study

Journal of Human Hypertension volume 28, pages 92–97 (2014)Cite this article

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Abstract

Excess aldosterone is associated with increased cardiovascular risk. Aldosterone has a permissive effect on vascular fibrosis. Cardiovascular magnetic resonance imaging (CMR) allows study of vascular function by measuring aortic distensibility. We compared aortic distensibility in primary aldosteronism (PA), essential hypertension (EH) and normal controls and explored the relationship between aortic distensibility and pulse wave velocity (PWV). We studied PA (n=14) and EH (n=33) subjects and age-matched healthy controls (n=17) with CMR, including measurement of aortic distensibility, and measured PWV using applanation tonometry. At recruitment, PA and EH patients had similar blood pressure and left ventricular mass. Subjects with PA had significantly lower aortic distensibility and higher PWV compared with EH and healthy controls. These changes were independent of other factors associated with reduced aortic distensibility, including ageing. There was a significant relationship between increasing aortic stiffness and age in keeping with physical and vascular ageing. As expected, aortic distensibility and PWV were closely correlated. These results demonstrate that PA patients display increased arterial stiffness compared with EH, independent of vascular ageing. The implication is that aldosterone invokes functional impairment of arterial function. The long-term implications of arterial stiffening in aldosterone excess require further study.

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Acknowledgements

We acknowledge the work of Tracey Steedman and Kirsten Lanaghan in performing cardiac MRI imaging. PBM is funded by Syskid European Union’s FP7, Grant agreement number HEALTH–F2–2009–241544. EMF is funded by a Clinician Scientist Fellowship awarded by the Medical Research Council (reference number G0802803). This study was supported by the European Union’s Seventh Framework Programme ‘EU-MASCARA’ and the British Heart Foundation Programme Grant RG/07/005/23633.

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Authors and Affiliations

  1. BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK

    P B Mark, S Boyle, E P McQuarrie, C Delles & E M Freel

  2. UniversitätsSpital Zürich, Klinik und Poliklinik für Inner Medizin, Zürich, Switzerland

    L U Zimmerli

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  1. P B Mark
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Correspondence to P B Mark.

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Mark, P., Boyle, S., Zimmerli, L. et al. Alterations in vascular function in primary aldosteronism: a cardiovascular magnetic resonance imaging study. J Hum Hypertens 28, 92–97 (2014). https://doi.org/10.1038/jhh.2013.70

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