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Cortisol excess in patients with primary aldosteronism impacts left ventricular hypertrophy

Journal of Clinical Endocrinology & Metabolism Nov 17, 2018

Adolf C, et al. - In patients with primary aldosteronism (PA), researchers studied the impact of cortisol cosecretion on left ventricular hypertrophy (LVH) by analyzing data of 73 patients (45 with unilateral aldosterone-producing adenoma and 28 with bilateral adrenal hyperplasia) from the Munich center of the German Conn’s registry. In multivariate analysis, the decrease in left ventricular mass index (LVMI) was not positively correlated with tetrahydroaldosterone excretion, but with total glucocorticoid excretion and systolic 24-hour blood pressure. In patients with PA, cortisol excess seems to have an additional impact on cardiac remodeling. LVMI improves treatment of PA by either adrenalectomy or mineralocorticoid receptor antagonist. This effect was most pronounced in high total glucocorticoid excretion patients.
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