Subclinical Primary Aldosteronism and Major Adverse Cardiovascular Events: A Longitudinal Population-Based Cohort Study
Authors' conclusion
Independent of blood pressure, the subclinical PA biochemical phenotype is associated with an increased risk of MACE.
Study context
- Population
- Canadian adults 40 to 69 years of age from the CARTaGENE cohort (Québec, Canada), aldosterone and renin measured at enrollment (2009–2010)
- Participants
- 2,017 adults
- Exposure
- Aldosterone, renin and aldosterone-to-renin ratio vs MACE risk
- Outcome
- MACE:
- MI
- Stroke
- Hospitalization for HF
- CV death
- Follow-up
- Median 10.8 years
Methodological detailsrandomly sampled, administrative database linkage
- Randomly sampled
- Administrative database linkage
Main finding
As reported in the abstract
MACE
Adjusted hazard ratio (95% CI)
Lower renin concentration
2.22(1.02–4.76)
Higher aldosterone-to-renin ratio
2.43(1.15–5.12)
Aldosterone concentrationno significant association
1.57(0.42–5.90)
Renin concentration ≤4.0 ng/Loutcome-derived optimal threshold
2.12(1.21–3.72)
Aldosterone-to-renin ratio ≥70 pmol/L per ng/Loutcome-derived optimal threshold
2.03(1.09–3.80)
Per ng/L, as printed
- MACE outcomes occurred
- 57 (3%)
Observational data: associations, not effects.
Original publication
Subclinical Primary Aldosteronism and Major Adverse Cardiovascular Events: A Longitudinal Population-Based Cohort Study. Circulation. Published 9 July 2025. doi:10.
Summarised from the published abstract; every number is checked against it