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When hormones hurt the heart

Subclinical primary aldosteronism linked with worse cardiovascular health

February 14, 2024

Dr. Gregory Hundemer“This study shows even mild forms of primary aldosteronism can hurt the heart and blood vessels, even before someone develops high blood pressure," -Dr. Gregory HundemerA hormonal disorder called primary aldosteronism is an often-missed cause of high blood pressure. There is growing evidence that a milder form called subclinical primary aldosteronism is common in the general population, but it's unclear how it impacts cardiovascular health. 

Using data from a random sample of 1,284 healthy Canadians who had a heart MRI, Dr. Gregory Hundemer led a study in Circulation that found individuals with subclinical primary aldosteronism were more likely to have stiffer arteries, high blood pressure, and structural changes to the heart that reduce its function. These impacts on the heart and blood vessels were seen even in people without high blood pressure, suggesting the hormone imbalance was causing the damage directly. 

“This study shows even mild forms of primary aldosteronism can hurt the heart and blood vessels, even before someone develops high blood pressure," said Dr. Gregory Hundemer, nephrologist and Lorna Jocelyn Wood Chair for Kidney Research at The Ottawa Hospital, assistant professor at the University of Ottawa.

The team recommends future studies look at whether more people with high blood pressure should be tested for primary aldosteronism earlier in their disease, and whether treating this hormone condition can help prevent cardiovascular outcomes.

Authors: Gregory L. Hundemer, Mohsen Agharazii, François Madore, Anand Vaidya, Jenifer M. Brown, Alexander A. Leung, Gregory A. Kline, Eric Larose, Marie-Eve Piché, Andrew M. Crean, Julie L.V. Shaw, Tim Ramsay, Bernhard Hametner, Siegfried Wassertheurer, Manish M. Sood, Swapnil Hiremath, Marcel Ruzicka, Rémi Goupil.

Funding: This study was funded by the Canadian Institutes of Health Research Institute of Nutrition, Metabolism and Diabetes, Kidney Foundation of Canada, Lorna Jocelyn Wood Chair for Kidney Research, National Institutes of Health, American Heart Association, Heart and Stroke Foundation of Canada, Fonds de Recherche du Québec–Santé, Société Québécoise d’Hypertension. All research at The Ottawa Hospital is enabled by generous donors to The Ottawa Hospital Foundation.

Core resources: Ottawa Methods Centre

The Ottawa Hospital is a leading academic health, research and learning hospital proudly affiliated with the University of Ottawa and supported by The Ottawa Hospital Foundation.


 

Disease and research area tags: Vascular, heart and metabolic disease

Scientific Program tags: Inflammation and Chronic Disease Program