PotassiumNEW2026-09

[Analysis of related factors for the occurrence of cardiovascular-renal-metabolic syndrome stage 4 in patients with primary aldosteronism].

Yang M X, Li B, Wang J X, Zhou Y et al. — Zhonghua yi xue za zhi

Summary

This study investigated factors contributing to severe cardiovascular, kidney, and metabolic problems in individuals with primary aldosteronism, a condition where the adrenal glands produce too much aldosterone. Researchers found that elevated aldosterone levels, particularly those measured after a specific medication test, were associated with a higher risk of developing the most advanced stage of these health issues. This suggests that managing aldosterone levels might be important for preventing serious complications in these patients.

AI-generated summary — read the original

Key points

Individuals with primary aldosteronism face an increased risk of developing severe cardiovascular, kidney, and metabolic health issues.
Elevated levels of the hormone aldosterone are associated with a higher likelihood of progressing to the most advanced stage of these health problems.
A specific aldosterone measurement taken after a captopril test was found to be a reliable indicator of this increased risk.
This association between aldosterone and severe health complications can differ among men and women, younger and older patients, and by the specific type of primary aldosteronism.

What the study looked at

This study aimed to identify factors that predict the progression to severe cardiovascular, kidney, and metabolic problems (known as CKM syndrome stage 4) in patients diagnosed with primary aldosteronism. Researchers looked back at the medical records of 397 patients with primary aldosteronism over several years. They categorized these patients into groups based on the severity of their CKM syndrome (early stage, stage 3, or stage 4). They then compared various health indicators and lab results among these groups and used statistical methods to pinpoint factors independently linked to reaching CKM stage 4. Subgroup analyses were also performed based on gender, age, and specific types of primary aldosteronism. The study found that higher levels of aldosterone, particularly a measurement taken two hours after a captopril test, were independently associated with a greater risk of developing CKM syndrome stage 4. This means that even after accounting for other health factors like age, BMI, and existing conditions, elevated aldosterone remained a significant predictor. The strength of this association varied across different patient groups, being more pronounced in men, younger patients (under 50), and those with a specific subtype of primary aldosteronism.

Dietary takeaway

This study, while focusing on a specific medical condition, underscores the importance of maintaining balanced electrolyte levels, including potassium, for overall cardiovascular and kidney health. For individuals with primary aldosteronism, who often experience potassium imbalances due to high aldosterone, careful management of blood potassium is crucial. While this research doesn't provide direct dietary advice for the general population, ensuring adequate potassium intake through a diet rich in fruits, vegetables, and legumes is generally beneficial for blood pressure and heart health. Remember, this is one study on a specific patient group, and broad dietary recommendations should always come from a healthcare professional.

Abstract

To explore the related factors of patients with primary aldosteronism (PA) developing into stage 4 of cardiovascular-renal-metabolic syndrome (CKM). A total of 397 patients diagnosed with PA from January 2016 to December 2024 were retrospectively enrolled. According to the CKM staging criteria, the patients were divided into the early stage group (stages 0-2), stage 3 group and stage 4 group. To analyze the differences in each indicator among the three groups. Multivariate logistic regression models were applied to analyze the correlation between each indicator and the occurrence of CKM stage 4 via stepwise adjustment for confounding factors. Subgroup analyses were further conducted by gender, age (≤50 years and >50 years) and PA subtypes [idiopathic hyperaldosteronism (IHA) and aldosterone-producing adenoma]. Among the 397 PA patients, 231 were males and 166 were females, with a confirmed diagnosis age of (51.1±10.9) years. There were 179 patients in the early CKM stage group (including 1 case in stage 0, 7 cases in stage 1, and 171 cases in stage 2), 107 patients in the CKM stage 3 group, and 111 patients in the CKM stage 4 group. There were statistically significant differences among the 3 groups in age, gender, PA subtype, body mass index, diastolic blood pressure, systolic blood pressure, hypertension duration, proportion of dyslipidemia, proportion of diabetes, proportion of atherosclerosis, proportion of chronic kidney disease, proportion of cerebral infarction, and proportion of coronary heart disease (all <0.05). In terms of laboratory indicators, there were statistically significant differences among the 3 groups in fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol, γ-glutamyl transferase, blood potassium, serum creatinine, urinary albumin/creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), supine aldosterone, and aldosterone 2 hours after the captopril test (all <0.05). Multivariate logistic regression showed that after adjusting for a series of influencing factors including gender, age, BMI, metabolic indicators, disease history and medication history, 2 h post-captopril aldosterone remained independently and positively correlated with the occurrence of CKM stage 4 in PA patients (=1.003, 95%: 1.001-1.005). Subgroup analyses revealed that the correlation between 2-hour post-captopril aldosterone and CKM stage 4 was more significant in the male subgroup (=1.005, 95%: 1.002-1.008),the subgroup aged ≤50 years (=1.006, 95%: 1.002-1.010) andthe IHA subgroup (=1.005, 95%: 1.002-1.008). High aldosterone level is a factor associated with progression of CKM to the clinical event phase (CKM stage 4). Among aldosterone-related indicators, 2 h post-captopril aldosterone has the most stable predictive value, and this correlation presents heterogeneity across populations with different genders, ages and PA subtypes.

View on PubMed →DOI: 10.3760/cma.j.cn112137-20260408-00949