Primary aldosteronism patients with previous cardiovascular and cerebrovascular events have high aldosterone responsiveness to ACTH stimulation
Aldosterone secretion in primary aldosteronism (PA) is often regulated by adrenocorticotropic hormone (ACTH) in addition to its autonomous secretion. However, the clinical characteristics and risk of cardiovascular and cerebrovascular (CCV) events in PA patients with aldosterone responsiveness to AC...
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The Japan Endocrine Society
2024-05-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/71/5/71_EJ23-0659/_html/-char/en |
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| author | Eriko Nakano Kosuke Mukai Atsunori Fukuhara Michio Otsuki Iichiro Shimomura Takamasa Ichijo Mika Tsuiki Norio Wada Takashi Yoneda Yoshiyu Takeda Kenji Oki Tetsuya Yamada Yoshihiro Ogawa Daisuke Yabe Miki Kakutani Masakatsu Sone Takuyuki Katabami Akiyo Tanabe Mitsuhide Naruse JPAS/JRAS Study Group |
| author_facet | Eriko Nakano Kosuke Mukai Atsunori Fukuhara Michio Otsuki Iichiro Shimomura Takamasa Ichijo Mika Tsuiki Norio Wada Takashi Yoneda Yoshiyu Takeda Kenji Oki Tetsuya Yamada Yoshihiro Ogawa Daisuke Yabe Miki Kakutani Masakatsu Sone Takuyuki Katabami Akiyo Tanabe Mitsuhide Naruse JPAS/JRAS Study Group |
| author_sort | Eriko Nakano |
| collection | DOAJ |
| description | Aldosterone secretion in primary aldosteronism (PA) is often regulated by adrenocorticotropic hormone (ACTH) in addition to its autonomous secretion. However, the clinical characteristics and risk of cardiovascular and cerebrovascular (CCV) events in PA patients with aldosterone responsiveness to ACTH stimulation remain unclear. This study aimed to investigate the prevalence of CCV events in PA patients with high aldosterone responsiveness to ACTH stimulation. A retrospective cross-sectional study was conducted as part of the Japan Primary Aldosteronism Study/Japan Rare Intractable Adrenal Disease project. PA patients with adrenal venous sampling (AVS) between January 2006 and March 2019 were enrolled. The ACTH-stimulated plasma aldosterone concentration (PAC) of the inferior vena cava during AVS was used to evaluate aldosterone responsiveness to ACTH. We analyzed the relationship between responsiveness and previous CCV events. Logistic regression analysis demonstrated that the ΔPAC (the difference between the PAC measurements before and after ACTH stimulation) significantly increased the odds of previous CCV events in PA patients after adjusting for classical CCV event risk factors, baseline PAC and duration of hypertension (relative PAC: odds ratio [OR], 2.896; 95% confidence interval [CI], 0.989–8.482; ΔPAC: OR, 2.344; 95% CI, 1.149–4.780; ACTH-stimulated PAC: OR, 2.098; 95% CI, 0.694–6.339). This study clearly demonstrated that aldosterone responsiveness to ACTH is closely related to previous CCV events. The responsiveness of the PAC to ACTH could be useful in predicting CCV event risk. Registration Number in UMIN-CTR is UMIN000032525. |
| format | Article |
| id | doaj-art-2a15feaf300c4695a06f7ae103b3b6c6 |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-2a15feaf300c4695a06f7ae103b3b6c62025-01-22T06:39:10ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402024-05-0171548949710.1507/endocrj.EJ23-0659endocrjPrimary aldosteronism patients with previous cardiovascular and cerebrovascular events have high aldosterone responsiveness to ACTH stimulationEriko Nakano0Kosuke Mukai1Atsunori Fukuhara2Michio Otsuki3Iichiro Shimomura4Takamasa Ichijo5Mika Tsuiki6Norio Wada7Takashi Yoneda8Yoshiyu Takeda9Kenji Oki10Tetsuya Yamada11Yoshihiro Ogawa12Daisuke Yabe13Miki Kakutani14Masakatsu Sone15Takuyuki Katabami16Akiyo Tanabe17Mitsuhide Naruse18JPAS/JRAS Study GroupDepartment of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, JapanDepartment of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, JapanDepartment of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, JapanDepartment of Endocrinology, Tokyo Woman’s Medical University, Tokyo 162-8666, JapanDepartment of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, JapanDepartment of Diabetes and Endocrinology, Saiseikai Yokohamashi Tobu Hospital, Kanagawa 230-8765, JapanDepartment of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, JapanDepartment of Diabetes and Endocrinology, Sapporo City General Hospital, 060-8604 Hokkaido, JapanDepartment of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Ishikawa 920-8640, JapanDepartment of Internal Medicine, Asanogawa General Hospital, Ishikawa 920-8621, JapanDepartment of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, JapanDepartment of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyusyu University, Fukuoka 812-8582, JapanDepartment of Diabetes, Endocrinology and Metabolism and Department of Rheumatology and Clinical Immunology, Gifu University Graduate School of Medicine, Gifu 501-1194, JapanDivision of Diabetes, Endocrinology, and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo 663-8501, JapanDivision of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, JapanDivision of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Kanagawa 241-0811, JapanDivision of Endocrinology, National Center for Global Health and Medicine, Tokyo 162-8655, JapanEndocrine Center, Ijinkai Takeda General Hospital, Kyoto 601-1495, JapanAldosterone secretion in primary aldosteronism (PA) is often regulated by adrenocorticotropic hormone (ACTH) in addition to its autonomous secretion. However, the clinical characteristics and risk of cardiovascular and cerebrovascular (CCV) events in PA patients with aldosterone responsiveness to ACTH stimulation remain unclear. This study aimed to investigate the prevalence of CCV events in PA patients with high aldosterone responsiveness to ACTH stimulation. A retrospective cross-sectional study was conducted as part of the Japan Primary Aldosteronism Study/Japan Rare Intractable Adrenal Disease project. PA patients with adrenal venous sampling (AVS) between January 2006 and March 2019 were enrolled. The ACTH-stimulated plasma aldosterone concentration (PAC) of the inferior vena cava during AVS was used to evaluate aldosterone responsiveness to ACTH. We analyzed the relationship between responsiveness and previous CCV events. Logistic regression analysis demonstrated that the ΔPAC (the difference between the PAC measurements before and after ACTH stimulation) significantly increased the odds of previous CCV events in PA patients after adjusting for classical CCV event risk factors, baseline PAC and duration of hypertension (relative PAC: odds ratio [OR], 2.896; 95% confidence interval [CI], 0.989–8.482; ΔPAC: OR, 2.344; 95% CI, 1.149–4.780; ACTH-stimulated PAC: OR, 2.098; 95% CI, 0.694–6.339). This study clearly demonstrated that aldosterone responsiveness to ACTH is closely related to previous CCV events. The responsiveness of the PAC to ACTH could be useful in predicting CCV event risk. Registration Number in UMIN-CTR is UMIN000032525.https://www.jstage.jst.go.jp/article/endocrj/71/5/71_EJ23-0659/_html/-char/enprimary aldosteronismadrenocorticotropic hormonealdosterone responsivenesscardiovascular and cerebrovascular eventsadrenal venous sampling |
| spellingShingle | Eriko Nakano Kosuke Mukai Atsunori Fukuhara Michio Otsuki Iichiro Shimomura Takamasa Ichijo Mika Tsuiki Norio Wada Takashi Yoneda Yoshiyu Takeda Kenji Oki Tetsuya Yamada Yoshihiro Ogawa Daisuke Yabe Miki Kakutani Masakatsu Sone Takuyuki Katabami Akiyo Tanabe Mitsuhide Naruse JPAS/JRAS Study Group Primary aldosteronism patients with previous cardiovascular and cerebrovascular events have high aldosterone responsiveness to ACTH stimulation Endocrine Journal primary aldosteronism adrenocorticotropic hormone aldosterone responsiveness cardiovascular and cerebrovascular events adrenal venous sampling |
| title | Primary aldosteronism patients with previous cardiovascular and cerebrovascular events have high aldosterone responsiveness to ACTH stimulation |
| title_full | Primary aldosteronism patients with previous cardiovascular and cerebrovascular events have high aldosterone responsiveness to ACTH stimulation |
| title_fullStr | Primary aldosteronism patients with previous cardiovascular and cerebrovascular events have high aldosterone responsiveness to ACTH stimulation |
| title_full_unstemmed | Primary aldosteronism patients with previous cardiovascular and cerebrovascular events have high aldosterone responsiveness to ACTH stimulation |
| title_short | Primary aldosteronism patients with previous cardiovascular and cerebrovascular events have high aldosterone responsiveness to ACTH stimulation |
| title_sort | primary aldosteronism patients with previous cardiovascular and cerebrovascular events have high aldosterone responsiveness to acth stimulation |
| topic | primary aldosteronism adrenocorticotropic hormone aldosterone responsiveness cardiovascular and cerebrovascular events adrenal venous sampling |
| url | https://www.jstage.jst.go.jp/article/endocrj/71/5/71_EJ23-0659/_html/-char/en |
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