Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases.
Hypertension. 2022 Apr;79(4):736-746. doi: 10.1161/HYPERTENSIONAHA.121.18342. Epub 2022 Jan 12.
Animal models demonstrate circulating aldosterone leads to aortic dissection and aneurysm, whereas data from humans are lacking. Therefore, we aimed to examine the associations of plasma aldosterone concentrations (PAC) with aortic dissection and aneurysm.
We identified patients with aortic dissection and aneurysm with assessed PAC before disease onset from hospital-based electronic database and set as case group. Simultaneously, age and gender-matched cohort with PAC measurement whereas without aortic dissection and aneurysm were selected as control group using ratio of 1:4. Multi-variable logistic regression analysis was used to assess the relationship of PAC with aortic dissection and aneurysm.
Totally, 133 cases and 531 controls (all hypertensive) were enrolled between 2004 and 2021, with 77.9% men, mean age of 55.5 years and PAC of 13.9 ng/dL. Case group showed significantly higher PAC(14.51 versus 13.65 ng/dL, =0.012) than did control group. In logistic regression analysis, higher PAC exhibited 1.68-fold higher odds (95% CI, 1.14-2.48, =0.008) for presence of aortic dissection and aneurysm, significant in adjusted model (odds ratio, 1.69 [95% CI, 1.11-2.57], =0.015). In stratified analysis, the association between the two was observed in women of all ages and in men with coronary artery disease. Sensitivity analysis by excluding those under interfering agents at PAC measurement and those with primary aldosteronism did not change the relationship of the two.
Higher PAC is associated with the increased odd for aortic dissection and aneurysm in patients with hypertension, even in the absence of primary aldosteronism, implying that PAC might be a target for prevention.
动物模型表明，循环中的醛固酮会导致主动脉夹层和动脉瘤，而人类的数据则缺乏。因此，我们旨在研究血浆醛固酮浓度（PAC）与主动脉夹层和动脉瘤的关系。
我们从医院电子数据库中确定了患有主动脉夹层和动脉瘤且在发病前评估了 PAC 的患者，并将其设为病例组。同时，我们使用 1:4 的比例，选择了年龄和性别相匹配、且未患有主动脉夹层和动脉瘤、并测量了 PAC 的队列作为对照组。多变量逻辑回归分析用于评估 PAC 与主动脉夹层和动脉瘤的关系。
2004 年至 2021 年间共纳入 133 例病例和 531 例对照（均为高血压患者），其中 77.9%为男性，平均年龄为 55.5 岁，PAC 为 13.9ng/dL。病例组的 PAC 明显高于对照组（14.51 与 13.65ng/dL，=0.012）。在逻辑回归分析中，较高的 PAC 显示出 1.68 倍的优势比（95%可信区间，1.14-2.48，=0.008），表明存在主动脉夹层和动脉瘤，在调整模型中也具有统计学意义（优势比，1.69[95%可信区间，1.11-2.57]，=0.015）。分层分析显示，这种关联在所有年龄段的女性和患有冠心病的男性中均存在。排除 PAC 测量时受干扰药物影响的患者和原发性醛固酮增多症患者的敏感性分析并未改变两者的关系。
在高血压患者中，较高的 PAC 与主动脉夹层和动脉瘤的发生几率增加有关，即使在没有原发性醛固酮增多症的情况下也是如此，这表明 PAC 可能是预防的靶点。
