ArticleHypertension (Dallas, Tex. : 1979)2020
Serum Aldosterone Concentration, Blood Pressure, and Coronary Artery Calcium: The Multi-Ethnic Study of Atherosclerosis.
Article in Hypertension (Dallas, Tex. : 1979), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT05688579 (Effect of Mineralcorticoid Recept Antagonist on Cardiovascular Disease in Patients With Hypertension and Hyperaldosteronemia：A Multicenter Randomized Controlled Study), which is not on this map. Cited by 57 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Mineralcorticoid Recept Antagonist on Cardiovascular Disease in Patients With Hypertension and Hyperaldosteronemia：A Multicenter Randomized Controlled Study
Who cites it
57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Primary Aldosteronism and Risk of Cardiovascular Outcomes: Genome-Wide Association and Mendelian Randomization Study.Journal of the American Heart Association · 2024Pooled it
- Cortisol Co-Secretion and Clinical Usefulness of ACTH Stimulation Test in Primary Aldosteronism: A Systematic Review and Biases in Epidemiological Studies.Frontiers in endocrinology · 2021Pooled it
- Predictors of long-term absence of coronary artery calcium in individuals with high blood pressure: results from the MESA study.Annals of medicine · 2023Trial
- Mechanisms for Mineralocorticoid-Driven Age-Related Hypertension: Potential Therapeutic Role of Mineralocorticoid Receptor Antagonists and Aldosterone Synthase Inhibitors.Circulation research · 2026Review
- Low-renin hypertension in incidental adrenal adenomas and response to aldosterone-targeted therapy: a prospective study.European journal of internal medicine · 2026Article
- Primary aldosteronism.Nature reviews. Disease primers · 2026Review
- Biological age acceleration in primary aldosteronism: associations with renin, aldosterone, aldosterone-to-renin ratio, and left ventricular mass index.Journal of hypertension · 2026Article
- A Mechanistic Framework Integrating Renal QSP-PK-PD and Machine Learning for Baseline-Informed Stratification of Diuretic Resistance.The AAPS journal · 2026Article
- Renin-Guided Risk Stratification and Therapy in Hypertension to Reduce Major Adverse Cardiovascular Outcomes.medRxiv : the preprint server for health sciences · 2026Article
- The Burden, Outcomes, and Management of Patients with Aldosterone Dysregulation: A Targeted Literature Review.Advances in therapy · 2026Review
- Aldosterone fuels the progression of cardiovascular-kidney -metabolic syndrome: focus on primary aldosteronism spectrum.Endocrine · 2026Review
- Association between aldosterone and the risk of cardiovascular disease in hypertensive patients: a cohort study.Frontiers in endocrinology · 2026Article
- Subclinical primary aldosteronism: toward a conceptual framework linking primary aldosteronism and low-renin hypertension.Frontiers in endocrinology · 2026Review
- Development and validation of a LASSO-selected machine learning prediction pipeline for predicting coronary artery calcification in a health check-up population.Frontiers in medicine · 2026Article
- Risk of Hypertension and Chronic Kidney Disease Following Aldosterone Dysregulation.American journal of hypertension · 2026Article
- The differentiation between primary aldosteronism and essential hypertension in left ventricular remodeling before and after treatment: a follow-up study with quantitative stress cardiac magnetic resonance imaging.Quantitative imaging in medicine and surgery · 2025Article
- The long antisense non-coding RNA HOXA transcript at the distal tip (LncRNA HOTTIP) in health and disease: a comprehensive review and in silico analysis.Naunyn-Schmiedeberg's archives of pharmacology · 2025Review
- Subclinical primary aldosteronism.Archives of endocrinology and metabolism · 2025Review
- Aldosterone and Cardiovascular Risk Across the Lifespan.Metabolites · 2025Review
- ACE Inhibition to Distinguish Low-Renin Hypertension From Primary Aldosteronism.Hypertension (Dallas, Tex. : 1979) · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
Aldosterone is a steroid hormone regulating fluid and electrolyte homeostasis and is known to increase the risk of atherosclerosis. In this study, we examined the associations of serum aldosterone concentrations with subclinical atherosclerosis and all-cause mortality. This study included 948 adults aged 46 to 88 years from the MESA (Multi-Ethnic Study of Atherosclerosis) with measurements of serum aldosterone and plasma renin activity and not taking antihypertensive medications. Coronary calcification was longitudinally assessed using Agatston coronary artery calcium score from computed tomography scans. All-cause mortality was ascertained from the medical record. The average age (SD) was 62.3 (9.4) years and 53% were male. Among 700 subjects who had follow-up coronary artery calcium score (median follow-up of 6.4 years), higher aldosterone levels (per 100 pg/mL) were associated with higher coronary artery calcium (relative ratio, 1.17 [95% CI, 1.04-1.32]), with the association being stronger in individuals with suppressed plasma renin activity (≤0.5 μg/L/hr). Systolic or diastolic blood pressure mediated around 45% of the total effect of aldosterone on coronary artery calcium. Over a median follow-up of 12.5 years (120 deaths identified among 948 subjects), aldosterone was associated with the increased risk of all-cause mortality when plasma renin activity was suppressed; hazard ratio per 100 pg/mL, 1.70 (95% CI, 1.10-2.63). In this study, we found that higher aldosterone levels were associated with the increased risk of subclinical coronary atherosclerosis and all-cause mortality particularly when renin was suppressed. Our findings indicate the importance of aldosterone levels (even within the reference range) with respect to the cardiovascular system and overall health.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.