Endocrine Abstracts

Introduction

Primary hyperaldosteronism (PHA) represents the most common cause of secondary hypertension. It is associated with a high risk of cardiovascular diseases (CVD), suggesting that aldosterone is implicated in the development of early atherosclerosis. Clinical studies have shown that atherogenic index of plasma (AIP) predicts cardiovascular risk. The aim of this study was to assess the associations between atherogenic index of plasma and cardiovascular and metabolic risk in patients with PHA.

Methods

We conducted a retrospective study including 37 patients with PHA. Clinical data and lipid profiles were obtained from patient’s medical file. AIP was calculated as log₁₀ (TG/HDL-C). It was categorized into low risk: < 0.1, moderate risk: [0.1–0.24] and high risk: > 0.24. The cardiovascular risk was assessed using Framingham Risk Score (FRS).

Results

There were 23 (62%) women and 14 (38%) men, with a mean age of 56.8 ± 12.6 years. Smoking, obesity, diabetes mellitus, dyslipidemia and metabolic syndrome were present in 27, 49, 32, 46, and 68% of cases, respectively. Low HDLc level, hypercholesterolemia, and hypertriglyceridemia were found in 65, 19, and 41% of cases, respectively. The mean level of AIP was 0.20 ± 0.25 in all patients, 0.26 ± 0.21 in patients with metabolic syndrome vs 0.07 ± 0.27 in those without metabolic syndrome (P = 0.014). AIP was positively correlated with age (r=0.372, P = 0.023) body mass index (r = 0.445, P = 0.006), total cholesterol level (r = 0.402, P = 0.014), triglycerides level (r = 0.708, P < 10^–3), FRS (r = 0.437, P = 0.007), and negatively correlated with HDLc level (r = 0.628, P < 10–3). No association with aldosterone level (P = 0.305) or aldosterone-to-renin ratio (P = 0.942) was found. According to AIP category, 32% (12) were in low risk group, 30% (11) were in moderate risk and 38% (14) were in high risk of CVD. An AIP level > 0.24 was positively associated with a FRS > 20% (Odds Ratio = 5.7, P = 0.022).

Conclusion

PHA is involved in atherosclerotic process because of endothelial dysfunction, myocardial fibrosis and lipid metabolism alteration. Our study underlines the power of AIP as a predictive biomarker of cardiovascular and metabolic risk, independently of aldosterone levels.