Cardiometabolic outcomes and mortality in medically treated primary aldosteronism: a retrospective cohort study

Publication date: Available online 9 November 2017 Source:The Lancet Diabetes & Endocrinology Author(s): Gregory L Hundemer, Gary C Curhan, Nicholas Yozamp, Molin Wang, Anand Vaidya Background Mineralocorticoid receptor (MR) antagonists are the recommended medical therapy for primary aldosteronism. Whether this recommendation effectively reduces cardiometabolic risk is not well understood. We aimed to investigate the risk of incident cardiovascular events in patients with primary aldosteronism treated with MR antagonists compared with patients with essential hypertension. Methods We did a cohort study using patients from a research registry from Brigham and Women's Hospital, Massachusetts General Hospital, and their affiliated partner hospitals. We identified patients with primary aldosteronism using International Classification of Disease, 9th and 10th Revision codes, who were assessed between the years 1991–2016 and were at least 18 years of age. We excluded patients who underwent surgical adrenalectomy, had a previous cardiovascular event, were not treated with MR antagonists, or had no follow-up visits after study entry. From the same registry, we identified a population with essential hypertension that was frequency matched by decade of age at study entry. We extracted patient cohort data and collated it into a de-identified database. The primary outcome was an incident cardiovascular event, defined as a composite of incident myocardial infarction or co...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research