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Open AccessArticle

Plasma Aldosterone Concentration as a Determinant for Statin Use among Middle-Aged Hypertensive Patients for Atherosclerotic Cardiovascular Disease

1
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
2
Division of Nephrology and Sinwu Branch, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan
3
Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan
4
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
5
Department of Internal Medicine, Division of Nephrology, National Taiwan University Hospital, Taipei 100, Taiwan
6
Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
7
Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan 320, Taiwan
8
Ministry of Health and Welfare, Shuang Ho Hospital, Taipei Medical University, Taipei 235, Taiwan
9
Cleveland Clinic Lerner College of Medicine and Glickman Urological and Kidney Institute, Cleveland Clinic, OH 441, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(11), 382; https://doi.org/10.3390/jcm7110382
Received: 31 August 2018 / Revised: 15 October 2018 / Accepted: 15 October 2018 / Published: 24 October 2018
(This article belongs to the Special Issue Developing Novel Therapies to Prevent Atherosclerosis)
The use of statin therapy on the prevention of atherosclerotic cardiovascular disease (ASCVD) is recommended by the American College of Cardiology (ACC) and the American Heart Association (AHA); nevertheless, its validation on primary aldosteronism (PA) patients has not been reported. We investigated the risk of incident ASCVD in middle-aged patients with PA compared with essential hypertension (EH) based on ACC/AHA recommendations. We enrolled 461 PA patients and 553 EH patients. Even though the ratio of metabolic syndrome in each group was similar, the PA group had higher systolic blood pressures, higher low-density lipoprotein levels, higher plasma aldosterone concentration (PAC), lower high-density lipoprotein levels, and higher 10-year ASCVD compared to the EH group. The discriminative power for predicting ASCVD by the recommended statin use from the ACC/AHA guidelines was proper in the PA group (i.e., under the receiver operating characteristic curve (95% confidence interval; 0.94 (0.91–0.96)). The generalized additive model showed patients with PAC higher than 60 ng/dL accompanying the standard timing of the statin use suggested by the ACC/AHA. The ACC/AHA guidelines have good discriminative power in the prediction of middle-aged high-risk hypertensive patients, while PAC identifies those high-risk individuals who may benefit from early statin therapy. View Full-Text
Keywords: plasma aldosterone concentration; atherosclerotic cardiovascular disease; ASCVD; statin; primary hyperaldosteronism; essential hypertension plasma aldosterone concentration; atherosclerotic cardiovascular disease; ASCVD; statin; primary hyperaldosteronism; essential hypertension
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Lin, J.-H.; Lin, Y.-F.; Wang, W.-J.; Lin, Y.-F.; Chueh, S.-C.J.; Wu, V.-C.; Chu, T.-S.; Wu, K.-D.; On behalf of the Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group. Plasma Aldosterone Concentration as a Determinant for Statin Use among Middle-Aged Hypertensive Patients for Atherosclerotic Cardiovascular Disease. J. Clin. Med. 2018, 7, 382.

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