Post-SIT plasma aldosterone is nonlinearly associated with nocturnal hypertension; prevalence is 81.3% in positive (>10 ng/dL), 72.2% borderline, 57.0% negative groups.
Does elevated post-saline infusion test plasma aldosterone concentration associate with increased prevalence of nocturnal hypertension in patients with suspected primary aldosteronism?
Higher levels of autonomous aldosterone secretion, indicated by post-SIT PAC, are nonlinearly associated with an increased prevalence of nocturnal hypertension in patients with suspected primary aldosteronism.
Absolute Event Rate: 0% vs 0%
Abstract BACKGROUND Nocturnal hypertension (NH) is a significant risk factor for target organ damage and all-cause mortality. Post-saline infusion test plasma aldosterone concentration (post-SIT PAC) serves as an indicator of autonomous aldosterone secretion level, but its link to NH is uncertain. This study aims to explore the association between post-SIT PAC levels and NH in patients with suspected primary aldosteronism (PA). METHODS Participants were classified into three groups after a saline infusion test (SIT): negative (post-SIT PAC 5 ng/dL, n = 86), borderline (post-SIT PAC 5-10 ng/dL, n = 180), and positive (post-SIT PAC 10 ng/dL, n = 75). Restricted cubic spline plots (RCS) were used to explore the dose-response relationship between post-SIT PAC and NH, while multivariable logistic regression models adjusted for potential confounders. RESULTS In this retrospective study, the overall prevalence of NH was 70.4%. A positive, nonlinear association was identified between post-SIT PAC and NH (P-nonlinear 0.05). After adjustment for multiple variables, post-SIT PAC remained significantly correlated with NH (OR = 1.08; 95% CI: 1.01-1.15; P 0.05), while basal PAC was not. Additionally, guideline-defined subgroups with elevated post-SIT PAC demonstrated a higher prevalence of NH (P 0.05). Specifically, NH prevalence was 81.3% (n = 75) in the positive subgroup, 72.2% (n = 180) in the borderline subgroup, and 57.0% (n = 86) in the negative subgroup. CONCLUSIONS The level of autonomous aldosterone secretion, rather than the basal aldosterone level, is relevant to potential PA patients at risk for NH. NH prevalence increases nonlinearly with higher post-SIT PAC levels.
Wang et al. (Sat,) reported a other. Post-SIT plasma aldosterone is nonlinearly associated with nocturnal hypertension; prevalence is 81.3% in positive (>10 ng/dL), 72.2% borderline, 57.0% negative groups.