Abstract
Purpose
The aim of our study was to evaluate the relationship between the 24-h blood pressure (BP) profile, plasma NT-proBNP levels and left ventricular hypertrophy (LVH) in subjects with primary aldosteronism (PA) compared to patients with essential hypertension (EH).
Methods
A total of 385 consecutive patients with PA [187 with aldosterone producing adenoma (APA) and 198 with idiopathic hyperaldosteronism (IHA)] and 385 patients with EH were matched based on age, sex, body mass index (BMI), BP values and duration of hypertension. Twenty-four-hour ambulatory BP monitoring (ABPM), plasma levels of NT-proBNP, left ventricular mass index (LVMI), and other clinical medical data were assessed in all patients.
Results
No differences in age, sex, BMI, clinical BP, 24-h mean BP, daytime BP, or duration of hypertension were found between groups. Nighttime systolic BP (130 ± 16 vs. 127 ± 17 mmHg, p < 0.05) and diastolic BP (82 ± 10 vs. 79 ± 11 mmHg, p < 0.01) were higher in PA patients than in EH patients. In addition, nocturnal BP decline was reduced, while median NT-proBNP (53.7 vs. 33.2 pg/ml, P < 0.001) and LVMI (113 ± 25 vs. 102 ± 26 g/m2, P < 0.001) were higher in PA patients than in EH patients. Moreover, the median NT-proBNP level was higher in APA patients than in IHA patients (68.0 vs. 42.4 pg/ml, P < 0.001). In stepwise multivariate regression analysis, LVMI was correlated with NT-proBNP, nighttime systolic BP and sex in PA patients.
Conclusions
Patients with PA show higher nighttime BP and NT-proBNP levels and lower nocturnal BP decline than those with EH. In addition, higher nocturnal systolic BP has been shown to be strongly associated with cardiac damage in PA patients.
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Acknowledgements
This study was supported by the National Natural Science Foundation of China [81800339, 81900440], Natural Science Foundation of Shanghai Science and Technology Committee [18ZR1431800], and Fund of Shanghai Municipal Commission of Health and Family Planning [201940413, 20194Y0171].
Funding
This study was supported by the National Natural Science Foundation of China [81800339, 81900440], Natural Science Foundation of Shanghai Science and Technology Committee [18ZR1431800], and Fund of Shanghai Municipal Commission of Health and Family Planning [201940413, 20194Y0171].
Author contributions
Substantially contributed to conception or design: Q.W. and M.H.; contributed to acquisition, analysis, or interpretation of data: Q.W. and M.H.; drafted the manuscript: J.X., X.T., and L.Z.; critically revised the manuscript for important intellectual content: P.G.; gave final approval: J.X. and J.W.
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Wu, Q., Hong, M., Xu, J. et al. Diurnal blood pressure pattern and cardiac damage in hypertensive patients with primary aldosteronism. Endocrine 72, 835–843 (2021). https://doi.org/10.1007/s12020-021-02606-3
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DOI: https://doi.org/10.1007/s12020-021-02606-3