Browsing by Author "Matthew A. Allison"

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    The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension
    (2017) Jenifer M. Brown; Cassianne Robinson-Cohen; Miguel Angel Luque-Fernandez; Matthew A. Allison; Rene Baudrand; Joachim H. Ix; Bryan Kestenbaum; Ian H. de Boer; Anand Vaidya
    Background: Primary aldosteronism is recognized as a severe form of renin-independent aldosteronism that results in excessive mineralocorticoid receptor (MR) activation. Objective: To investigate whether a spectrum of subclinical renin-independent aldosteronism that increases risk for hypertension exists among normotensive persons. Design: Cohort study. Setting: National community-based study. Participants: 850 untreated normotensive participants in MESA (Multi-Ethnic Study of Atherosclerosis) with measurements of serum aldosterone and plasma renin activity (PRA). Measurements: Longitudinal analyses investigated whether aldosterone concentrations, in the context of physiologic PRA phenotypes (suppressed, ≤0.50 μg/L per hour; indeterminate, 0.51 to 0.99 μg/L per hour; unsuppressed, ≥1.0 μg/L per hour), were associated with incident hypertension (defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or initiation of antihypertensive medications). Cross-sectional analyses investigated associations between aldosterone and MR activity, assessed via serum potassium and urinary fractional excretion of potassium.