Document Detail


Arterial stiffness, intima-media thickness and carotid artery fibrosis in patients with primary aldosteronism.
MedLine Citation:
PMID:  19008719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate vascular wall structure and conduit artery stiffness in patients with primary aldosteronism. METHODS: This observational study, conducted in a University Hypertension Center, evaluated the carotid wall by 2-D ultrasonography and ultrasonic tissue characterization, and analyzed arterial stiffness by applanation tonometer. Twenty-three consecutive patients with primary aldosteronism, 24 matched patients with essential hypertension and 15 controls were studied. Intima-media thickness and corrected integrated backscatter signal of the carotid arteries were evaluated. Radial and femoral pulse wave velocity and aortic augmentation index were also investigated. RESULTS: Intima-media thickness in patients with essential hypertension (0.69 +/- 0.03 mm) was higher (P < 0.04) than that in controls (0.59 +/- 0.02 mm). This finding was more evident in primary aldosteronism patients (0.84 +/- 0.03 mm), in whom intima-media thickness was greater than that in controls (P < 0.0001) or in patients with essential hypertension (P < 0.01). Similarly, corrected integrated backscatter signal in patients with essential hypertension (-23.6 +/- 0.35 dB) was higher (P < 0.0001) than that in controls (-26.2 +/- 0.44 dB), but it was even more elevated in patients with primary aldosteronism (-22.1 +/- 0.46 dB), who showed greater corrected integrated backscatter signal than was the case in patients with essential hypertension (P < 0.009) or in controls (P < 0.0001). Femoral pulse wave velocity was higher in primary aldosteronism patients (10.8 +/- 0.57 m/s) than in patients with essential hypertension (9.1 +/- 0.34 m/s, P < 0.03) or in controls (7.1 +/- 0.51 m/s, P < 0.0001). Femoral pulse wave velocity was lower in controls than in patients with essential hypertension (P < 0.0001). The same pattern was observed for radial pulse wave velocity. Aortic augmentation index was higher in primary aldosteronism patients (28.2 +/- 2.1%) than in patients with essential hypertension (26.0 +/- 1.8%) or in controls (16.8 +/- 2.0%, P < 0.001). Patients with essential hypertension likewise exhibited higher aortic augmentation index than controls (P < 0.001). CONCLUSION: Aldosterone excess is responsible per se for vascular morphological (wall thickening and carotid artery fibrosis) and functional (central stiffness) damage.
Authors:
Giampaolo Bernini; Fabio Galetta; Ferdinando Franzoni; Michele Bardini; Chiara Taurino; Melania Bernardini; Lorenzo Ghiadoni; Matteo Bernini; Gino Santoro; Antonio Salvetti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  26     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-14     Completed Date:  2009-02-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  2399-405     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University of Pisa, Pisa, Italy. g.bernini@med.unipi.it
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MeSH Terms
Descriptor/Qualifier:
Aorta / physiopathology
Carotid Arteries / pathology*,  physiopathology*,  ultrasonography
Case-Control Studies
Elasticity / physiology*
Female
Femoral Artery / physiopathology
Fibrosis
Humans
Hyperaldosteronism / pathology*,  physiopathology*
Hypertension / pathology,  physiopathology
Male
Middle Aged
Pulsatile Flow / physiology
Radial Artery / physiopathology
Regional Blood Flow / physiology
Tunica Intima / pathology*,  ultrasonography
Tunica Media / pathology*,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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