Association of Aldosterone with Mortality in the General
                    Population

Cornelia Then; Christian Herder; Margit Heier; Christa Meisinger; Wolfgang Koenig; Wolfgang Rathmann; Chaterina Sujana; Michael Roden; Martin Bidlingmaier; Jochen Seissler; Barbara Thorand; Annette Peters; Martin Reincke

doi:10.1055/a-2035-6179

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2023; 131(05): 307-313
DOI: 10.1055/a-2035-6179

Article

Association of Aldosterone with Mortality in the General Population

Cornelia Then

¹Department of Internal Medicine IV, University Hospital of Ludwig-Maximilians-University Munich, Germany

²German Center for Diabetes Research (DZD), Partner Munich-Neuherberg, Germany

,

Christian Herder

³German Center for Diabetes Research (DZD), Partner Düsseldorf, Germany

⁴Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf; Germany

⁵Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Germany

,

Margit Heier

⁶Institute of Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

⁷KORA Study Centre, University Hospital Augsburg, Germany

,

Christa Meisinger

⁸Independent Research Group Clinical Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

⁹Chair of Epidemiology, University Hospital Augsburg, Germany

,

Wolfgang Koenig

¹⁰DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany

¹¹Institute of Epidemiology and Medical Biometry, University of Ulm, Germany

¹²German Heart Center Munich, Technical University of Munich, Germany

,

Wolfgang Rathmann

³German Center for Diabetes Research (DZD), Partner Düsseldorf, Germany

¹³Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute at Heinrich-Heine-University Düsseldorf, Germany

,

Chaterina Sujana

⁶Institute of Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

,

Michael Roden

³German Center for Diabetes Research (DZD), Partner Düsseldorf, Germany

⁴Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf; Germany

⁵Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Germany

,

Martin Bidlingmaier

¹Department of Internal Medicine IV, University Hospital of Ludwig-Maximilians-University Munich, Germany

,

Jochen Seissler

¹Department of Internal Medicine IV, University Hospital of Ludwig-Maximilians-University Munich, Germany

,

Barbara Thorand

⁶Institute of Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

,

Annette Peters^*

⁶Institute of Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

¹⁰DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany

,

Martin Reincke^*

¹Department of Internal Medicine IV, University Hospital of Ludwig-Maximilians-University Munich, Germany

› Author Affiliations

Abstract

Introduction Aldosterone excess is linked to cardiovascular events and mortality as well as to low-grade inflammation in the context of metabolic diseases. Whether mildly elevated aldosterone levels in the general population promote cardiovascular risk is still under debate. We analyzed the association of plasma aldosterone concentrations with incident cardiovascular events, cardiovascular and all-cause mortality as well as with biomarkers of subclinical inflammation in the population-based KORA F4 study.

Methods Plasma aldosterone concentrations were measured with an in-house immunoflurometric assay. The analyses included 2935 participants (n=1076 for selected biomarkers of subclinical inflammation) with a median follow-up of 8.7 (8.2; 9.1) years. The associations were estimated using Cox proportional hazard and linear regression models adjusted for renin, sex, age, body mass index, arterial hypertension, diabetes, estimated glomerular filtration rate, low- and high-density lipoprotein cholesterol, physical activity, smoking, use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, diuretics and calcium channel blockers.

Results Aldosterone was significantly associated with all-cause mortality (hazard ratio per standard deviation increase: 1.20; 95% confidence interval 1.04–1.37), but not with cardiovascular mortality, incident cardiovascular events, or with biomarkers of subclinical inflammation.

Conclusions Aldosterone was associated with all-cause mortality in the population-based KORA F4 study, but the previously described associations of excess aldosterone with cardiovascular complications and biomarkers of subclinical inflammation could not be shown.

Key words

renin - stroke - myocardial infarction - general population

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Supplementary Material

Supplementary Material