Differences in the presentation and evolution of primary aldosteronism in elderly (≥65 years) and young patients (<65 years)

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Publicated to:Endocrine Connections. 11 (6): EC-0169 - 2022-06-01 11(6), DOI: 10.1530/ec-22-0169

Authors: Parra Ramirez, Paola; Martin Rojas-Marcos, Patricia; Paja Fano, Miguel; Gonzalez Boillos, Marga; Pascual-Corrales, Eider; Garcia-Cano, Ana; Gabriel Ruiz-Sanchez, Jorge; Vicente, Almudena; Gomez-Hoyos, Emilia; Ferreira, Rui; Garcia Sanz, Inigo; Recasens, Monica; Pla Peris, Begona; Barahona San Millan, Rebeca; Picon Cesar, Maria Jose; Diaz Guardiola, Patricia; Garcia Gonzalez, Juan Jesus; Perdomo, Carolina; Manjon, Laura; Garcia-Centeno, Rogelio; Carlos Percovich, Juan; Rebollo Roman, Angel; Gracia Gimeno, Paola; Robles Lazaro, Cristina; Morales, Manuel; Hanzu, Felicia; Araujo-Castro, Marta

Affiliations

Biochemistry Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. - Author

CiberOBN, Madrid, Spain - Author

CIBEROBN, Madrid, Spain. - Author

Clin Univ Navarra, Endocrinol & Nutr Dept, Pamplona, Spain - Author

Complejo Hosp Malaga Hosp Virgen de la Victoria, Endocrinol & Nutr Dept, IBIMA Malaga, Malaga, Spain - Author

Complejo Univ Toledo, Endocrinol & Nutr Dept, Toledo, Spain - Author

Endocrinology & Nutrition Department, Clínica Universidad de Navarra, Pamplona, Spain. - Author

Endocrinology & Nutrition Department, Hospital Clinic, Barcelona, Spain. - Author

Endocrinology & Nutrition Department, Hospital Reina Sofía, Córdoba, Spain. - Author

Endocrinology & Nutrition Department, Hospital Universitario Central de Asturias, Oviedo, Spain. - Author

Endocrinology & Nutrition Department, Hospital Universitario de Castellón, Castellón, Spain. - Author

Endocrinology & Nutrition Department, Hospital Universitario de La Princesa, Madrid, Spain. - Author

Endocrinology & Nutrition Department, Hospital Universitario Infanta Sofía, Madrid, Spain. - Author

Endocrinology & Nutrition Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. - Author

Endocrinology & Nutrition Department, Hospital Universitario Virgen de la Macarena, Sevilla, Spain. - Author

General & Digestive Surgery Department, Hospital Universitario de La Princesa, Madrid, Spain. - Author

Hosp Clin Barcelona, Biochem & Mol Genet Dept CDB, CIBERehd, IDIBAPS, Barcelona, Spain - Author

Hosp Clin Barcelona, Endocrinol & Nutr Dept, Barcelona, Spain - Author

Hosp Clin Univ Valladolid, Endocrinol & Nutr Dept, Valladolid, Spain - Author

Hosp Fdn Jimenez Diaz, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Gen Univ Gregorio Maranon, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Josep Trueta, Endocrinol & Nutr Dept, Serv Endocrinol, Girona, Spain - Author

Hosp Reina Sofia, Endocrinol & Nutr Dept, Cordoba, Spain - Author

Hosp Royo Villanova, Endocrinol & Nutr Dept, Zaragoza, Spain - Author

Hosp Univ Basurto, Endocrinol & Nutr Dept, Bilbao, Spain - Author

Hosp Univ Castellon, Endocrinol & Nutr Dept, Castellon de La Plana, Spain - Author

Hosp Univ Cent Asturias, Endocrinol & Nutr Dept, Oviedo, Spain - Author

Hosp Univ Infanta Sofia, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Univ La Princesa, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Univ La Princesa, Gen & Digest Surg Dept, Madrid, Spain - Author

Hosp Univ Ramon y Cajal, Biochem Dept, Madrid, Spain - Author

Hosp Univ Ramon y Cajal, Endocrinol & Nutr Dept, Madrid, Spain - Author

Hosp Univ Salamanca, Endocrinol & Nutr Dept, Salamanca, Spain - Author

Hosp Univ Virgen de la Macarena, Endocrinol & Nutr Dept, Seville, Spain - Author

Inst Invest Biomed Ramon y Cajal IRYCIS, Madrid, Spain - Author

Inst Invest Sanitaria Principado Asturias ISPA, Oviedo, Spain - Author

Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain. - Author

Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. - Author

La Paz Univ Hosp, Endocrinol & Nutr Dept, Madrid, Spain - Author

Univ Alcala, Madrid, Spain - Author

Univ Basque Country, Med Dept, Bilbao, Spain - Author

Abstract

Objective: To compare the presentation and evolution of primary aldosteronism (PA) in the elderly (?65 years) and young patients (<65 years). Methods: A retrospective multicenter study was performed in 20 Spanish hospitals of PA patients in follow-up between 2018 and 2021. Results: Three hundred fifty-two patients with PA <65 years and 88 patients ?65 years were included. Older PA patients had a two-fold higher prevalence of type 2 diabetes, dyslipidemia, and cerebrovascular disease, but these differences disappeared after adjusting for hypertension duration. At diagnosis, diastolic blood pressure was lower than in young patients (83.3 ± 11.54 vs 91.6 ± 14.46 mmHg, P < 0.0001). No differences in the rate of overall correct cannulation (56.5% vs 42.3%, P = 0.206) or the diagnosis of unilaterality (76.9% vs 62.5%, P = 0.325) in the adrenal venous sampling (AVS) was observed between the elderly and young groups. However, there was a lower proportion of PA patients who underwent adrenalectomy in the elderly group than in the younger group (22.7% (n = 20) vs 37.5% (n = 132), P = 0.009). Nevertheless, no differences in the rate of postsurgical biochemical (100% (n = 14) vs 92.8% (n = 90), P = 0.299) and hypertension cure (38.6% (n = 51) vs 25.0% (n = 5), P = 0.239) were observed between both groups. Conclusion: Older patients with PA have a worse cardiometabolic profile than young patients with PA that it is related to a longer duration of hypertension. However, the results of the AVS, and adrenalectomy are similar in both groups. Therefore, the management of elderly patients with PA should be based not only on age, but rather on the overall medical, physical, social, and mental characteristics of the patients. © 2022 The authors Published by Bioscientifica Ltd.

Keywords

adrenal venous samplingadrenalectomyblood-pressureconsensusdiagnosiselderlyhypertensionmanagementoutcomesprevalenceAdolescentAdrenal venous samplingAdrenalectomyAdultAgedAldosteroneAlpha adrenergic receptor blocking agentAntihypertensive agentArticleBeta adrenergic receptor blocking agentBiochemical analysisBody massCalcium channel blocking agentCannulationCaptoprilCerebrovascular diseaseChildChronic kidney failureComputed tomographic angiographyControlled studyCorticotropinDemographicsDiabetes mellitusDiastolic blood pressureDiuretic agentDyslipidemiaElderlyEuropean-societyFemaleFollow upGlucocorticoidHumanHypertensionHypokalemiaMajor clinical studyMaleMiddle agedMulticenter studyNon insulin dependent diabetes mellitusPlasma renin activityPostoperative complicationPrevalencePrimary aldosteronismPrimary hyperaldosteronismRetrospective studySleep disordered breathingYoung adult

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The work has been published in the journal Endocrine Connections due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position , thus managing to position itself as a Q2 (Segundo Cuartil), in the category Internal Medicine. Notably, the journal is positioned en el Cuartil Q3 for the agency WoS (JCR) in the category Endocrinology & Metabolism.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 3.74, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-15, the following number of citations:

WoS: 7
Scopus: 6
Europe PMC: 3
OpenCitations: 6

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