オオツキ　ミチオ   Michio Otsuki   大月　道夫    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Prevalence of Cardiovascular Disease and Its Risk Factors in Primary Aldosteronism: A Multicenter Study in Japan
掲載誌名	正式名：Hypertension 略　 称：Hypertension ISSNコード：0194911X/15244563
掲載区分	国外
巻・号・頁	71(3),pp.530-537
著者・共著者	Ohno, Y. Sone, M. Inagaki, N. Yamasaki, T. Ogawa, O. Takeda, Y. Kurihara, I. Itoh, H. Umakoshi, H. Tsuiki, M. Ichijo, T. Katabami, T. Tanaka, Y. Wada, N. Shibayama, Y. Yoshimoto, T. Ogawa, Y. Kawashima, J. Takahashi, K. Fujita, M. Watanabe, M. Matsuda, Y. Kobayashi, H. Shibata, H. Kamemura, K. Otsuki, M. Fujii, Y. Yamamoto, K. Ogo, A. Okamura, S. Miyauchi, S. Fukuoka, T. Izawa, S. Yoneda, T. Hashimoto, S. Yanase, T. Suzuki, T. Kawamura, T. Tabara, Y. Matsuda, F. Naruse, M.
発行年月	2018
概要	There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) in patients with primary aldosteronism (PA); however, their results have left it unclear whether CVD is affected by the plasma aldosterone concentration or hypokalemia. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalence of CVD among patients with PA with that among age-, sex-, and blood pressure-matched essential hypertension patients and participants with hypertension in a general population cohort. We also performed binary logistic regression analysis to determine which parameters significantly increased the odds ratio for CVD. Of the 2582 patients with PA studied, the prevalence of CVD, including stroke (cerebral infarction, cerebral hemorrhage, or subarachnoid hemorrhage), ischemic heart disease (myocardial infarction or angina pectoris), and heart failure, was 9.4% (stroke, 7.4%; ischemic heart disease, 2.1%; and heart failure, 0.6%). The prevalence of CVD, especially stroke, was higher among the patients with PA than those with essential hypertension/hypertension. Hypokalemia (K(+)</=3.5 mEq/L) and the unilateral subtype significantly increased adjusted odds ratios for CVD. Although aldosterone levels were not linearly related to the adjusted odds ratio for CVD, patients with plasma aldosterone concentrations>/=125 pg/mL had significantly higher adjusted odds ratios for CVD than those with plasma aldosterone concentrations<125 pg/mL. Thus, patients with PA seem to be at a higher risk of developing CVD than patients with essential hypertension. Moreover, patients with PA presenting with hypokalemia, the unilateral subtype, or plasma aldosterone concentration>/=125 pg/mL are at a greater risk of CVD and have a greater need for PA-specific treatments than others.
DOI	10.1161/hypertensionaha.117.10263
文献番号	29358460