Aldosterone is Associated with New-onset Cerebrovascular Events in Patients with Hypertension and White Matter Lesions: A cohort study

Yujuan Yuan; Nanfang Li; Lei Wang; Mulalibieke Heizhati; Yan Liu; Qing Zhu; Jing Hong; Ting Wu

doi:10.1016/j.eprac.2024.05.004

Aldosterone is Associated with New-onset Cerebrovascular Events in Patients with Hypertension and White Matter Lesions: A cohort study

Endocr Pract. 2024 May 9:S1530-891X(24)00514-7. doi: 10.1016/j.eprac.2024.05.004. Online ahead of print.

Authors

Yujuan Yuan¹, Nanfang Li², Lei Wang¹, Mulalibieke Heizhati¹, Yan Liu³, Qing Zhu¹, Jing Hong¹, Ting Wu¹

Affiliations

¹ 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.
² 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. Electronic address: lnanfang2016@sina.com.
³ Radiography Center of People's Hospital of Xinjiang Uygur Autonomous Region.

PMID: 38734410
DOI: 10.1016/j.eprac.2024.05.004

Abstract

Objective: White matter lesions (WMLs) increase the risk of stroke, stroke recurrence, and death. Higher plasma aldosterone concentration (PAC) increases the risk of stroke, acute myocardial infarction, and hypertension. To evaluate the relationship between PAC and cerebrovascular events in patients with hypertension and WMLs.

Methods: We conducted a retrospective cohort study that included 1041 participants hospitalized. The outcome was new-onset cerebrovascular events including intracerebral hemorrhage and stroke. A Cox regression model was used to evaluate the relationship between baseline PAC and the risk of cerebrovascular events.

Results: The mean age of participants was 60.9±10.2 years, and 565 (53.4%) were males. The median follow-up duration was 42 months (interquartile range [IQR]: 25-67), and 92 patients experienced new-onset cerebrovascular events. In a multivariate-adjusted model, with PAC as a continuous variable, higher PAC increased the risk of cerebrovascular events; patient risk increased per 1 (hazard ratio [HR: 1.03], 95% confidence interval [CI]: 1.01-1.06, P < 0.01), per 5 (HR: 1.17, 95% CI: 1.06-1.31, P < 0.01), and per 10 ng/dL (HR: 1.41, 95%: 1.14-1.75, P < 0.01) increase in PAC. When PAC was expressed as a categorical variable (quartile: Q1-Q4), patients in Q4 (HR: 2.12, 95% CI: 1.18-3.79, P < 0.05) exhibited an increased risk of cerebrovascular events compared to Q1. Restrictive spline regression showed a linear association between PAC and the risk of new-onset cerebrovascular events after adjusting for all possible variables.

Conclusions: Our study identified a linear association between PAC and the risk of new-onset cerebrovascular events in patients with hypertension and WMLs.

Keywords: Cerebrovascular events; Hypertension; Plasma aldosterone concentration; White matter lesions.