HypertensionCohort study
Spectrum of Primary Aldosteronism and Risk of Cardiovascular Outcomes
- Prospective cohort study
Authors' conclusion
The findings of this cohort study underscore a spectrum of primary aldosteronism, in which higher ARR was independently associated with increased risks of AF and ischemic stroke among older adults
Study context
- Population
- Community-dwelling older adults in the Atherosclerosis Risk in Communities (ARIC) study free of heart failure (HF), myocardial infarction (MI), stroke and potassium-sparing diuretic use at visit 5 (2011–2013)
- Participants
- 3,477 adults
- Exposure
- Higher vs lower aldosterone-renin ratio, per doubling
- Outcome
- Incident HF hospitalization, atrial fibrillation (AF), ischemic stroke, MI, and a composite of these events plus all-cause death
- Follow-up
- 9 years
Main finding
As reported in the abstract
Association of ARR (per doubling) with incident CV events · 9 years
ARR per doublingAdjusted hazard ratio (95% CI)
composite outcome
1.04(1.01–1.08)
stroke
1.13(1.02–1.26)
AF
1.10(1.05–1.15)
incident HF hospitalization
1.02(0.96–1.07)
MI
1.01(0.92–1.12)
Per doubling, as printed
Observational data: associations, not effects.
Further findings
Baseline aldosterone parameters
- Aldosterone level, median (IQR)
- 5.1 (3.0-8.3) ng/dL
- Renin activity, median (IQR)
- 0.78 (0.41-1.90) ng/mL per hour
- Aldosterone-renin ratio (ARR), median (IQR)
- 5.9 (2.2-12.3) ng/dL per ng/mL/h
Original publication
Spectrum of Primary Aldosteronism and Risk of Cardiovascular Outcomes. JAMA Cardiol. Published 1 April 2026. doi:10.1001/jamacardio.2026.0068
Summarised from the published abstract; every number is checked against it