Observational Study Mortality in Treated Primary Aldosteronism The German Conn's Registry
Observational Study Mortality in Treated Primary Aldosteronism The German Conn's Registry
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DOI：
10.1161/hypertensionaha.112.197111
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发表时间：
2012-09-01
期刊：
影响因子：
8.3
通讯作者：
Endres, Stephan
中科院分区：
文献类型：
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作者：
Reincke, Martin;Fischer, Evelyn;Endres, Stephan
与原发性高血压相比，原发性醛固酮增多症（PA）与心血管发病风险增加相关。迄今为止，尚未公布死亡率数据。我们评估了德国康涅狄格州登记处接受 PA 治疗的患者的死亡率，并在病例对照研究中确定了不良结果的危险因素。分析中纳入了自 1994 年以来在德国 3 个大学中心接受治疗的确诊 PA 患者。 2009 年和 2010 年我们联系了所有患者以核实生命状况。来自奥格斯堡地区合作健康研究的基于人群的 F3 调查的受试者作为对照。最终分析基于 600 名正常血压对照者、600 名高血压对照者和 300 名 PA 患者。计算了两个队列的卡普兰-迈耶生存曲线。血压正常对照者的十年总生存率为 95%，高血压对照者为 90%，PA 患者为 90%（P 值不显着）。在多变量分析中，年龄（风险比，每年 1.09 [95% CI，1.03-1.14]）、心绞痛（风险比，3.6 [95% CI，1.04 -12.04]）和糖尿病（风险比，2.55 [95% CI，1.07-6.09]）与全因风险增加相关死亡率，而低钾血症（风险比，0.41/mmol/L [95% CI，0.17-0.99]）与死亡率降低相关。心血管死亡率是 PA 的主要原因（高血压对照组为 50%，高血压对照组为 34%；P < 0.05）。这些数据表明，接受 PA 治疗的患者心血管死亡率增加，而全因死亡率与匹配的高血压对照者没有不同。 （高血压。2012 年；60：618-624。）。在线数据补充
In comparison with essential hypertension, primary aldosteronism (PA) is associated with an increased risk of cardiovascular morbidity. To date, no data on mortality have been published. We assessed mortality of patients treated for PA within the German Conn's registry and identified risk factors for adverse outcome in a case-control study. Patients with confirmed PA treated in 3 university centers in Germany since 1994 were included in the analysis. All of the patients were contacted in 2009 and 2010 to verify life status. Subjects from the population-based F3 survey of the Cooperative Health Research in the Region of Augsburg served as controls. Final analyses were based on 600 normotensive controls, 600 hypertensive controls, and 300 patients with PA. Kaplan-Meyer survival curves were calculated for both cohorts. Ten-year overall survival was 95% in normotensive controls, 90% in hypertensive controls, and 90% in patients with PA (P value not significant). In multivariate analysis, age (hazard ratio, 1.09 per year [95% CI, 1.03-1.14]), angina pectoris (hazard ratio, 3.6 [95% CI, 1.04 -12.04]), and diabetes mellitus (hazard ratio, 2.55 [95% CI, 1.07-6.09]) were associated with an increase in all-cause mortality, whereas hypokalemia (hazard ratio, 0.41 per mmol/ L [95% CI, 0.17-0.99]) was associated with reduced mortality. Cardiovascular mortality was the main cause of death in PA (50% versus 34% in hypertensive controls; P < 0.05). These data indicate that cardiovascular mortality is increased in patients treated for PA, whereas all-cause mortality is not different from matched hypertensive controls. (Hypertension. 2012; 60: 618-624.). Online Data Supplement