Abstract 16082: Predictors of the Long-Term Outcomes in Patients With Secondary Hypertension Caused by Primary Aldosteronism
Background: Secondary hypertension caused by primary aldosteronism plays an important role in end-organ damage. However, there are few studies about the long-term outcomes in this population. The aims of our study were to investigate the predictors of the long-term outcomes in secondary hypertension.
Methods: Patients who fulfilled the following criteria were enrolled: (1) age < 50 years old, (2) systolic blood pressure ≥ 160mmHg or diastolic blood pressure ≥ 100mmHg, (3) history of primary aldosteronism, and (4) follow up in our hospital for more than 1 year. All of the patients received a serial of studies to confirm the diagnosis. Endpoints of the study included cardiac events (acute coronary syndrome, atrial fibrillation or heart failure), cerebral events (stroke or transient ischemic attack) and the composite endpoints. Cox proportional hazard regression model was performed to evaluate the independent predictors of the long-term outcomes.
Results: A total of 88 patients (32.20 ± 9.49 years old, 56.8% male) with suspected secondary hypertension were enrolled into our study. After follow up for 11.02 ± 4.97 years, there were totally 12 events, including 7 (7.95%) cases of acute coroanry syndrome, 2 (2.27%) cases of congestive heart failure, 2 (2.27%) cases of new-onset atrial fibrillation, and 1 (1.13%) case of stroke. After multivariate analysis, age (hazard ratio, 1.14; 95% confident interval 1.02 - 1.28, p= 0.023), serum potassium concentration (hazard ratio, 0.20; 95% confident interval 0.05 - 0.84, p=0.028), and serum creatinine (hazard ratio, 2.51; 95% confident interval 1.06 - 5.95, p=0.37) predicted the composite endpoints in the patients with secondary hypertension. (Table)
Conclusion: Advanced age, elevated serum creatinine and lower serum potassium concentration could predict the poor long-term outcome in patients with secondary hypertension caused by primary aldosteronism. More aggressive treatment should be given in these patients.
- © 2013 by American Heart Association, Inc.