Correlations between plasma aldosterone levels and ventricular-arterial coupling in adult outpatient with essential hypertension: role of gender

Background: Plasma aldosterone level (PRA) determine an increased risk of cardiovascular events, independent of blood pressure (BP) values. Aim of the study:To evaluate the potential correlations between plasma aldosterone (PA) levels and ventricular-arterial coupling (VAC), a parameter of myocardial efficiency, in adult outpatients with essential hypertension, and to estimate potential impact of gender differences. Results: We included 182 hypertensive outpatients, who has been divided in two groups according to gender (34.6% female; 65% male). We found that PRA resulted significantly and positively correlated with VAC (Pearson r: 0.236; P=0.001), whilst no significance correlations were found between its single components, even if a trend towards augmentation (Pearson r: 0.107; P=0.145) and reduction (Pearson r: -0.63; P=0.391) was found, respectively for arterial and ventricular elastance. PRA correlate positively with BP levels (p<0,001), as well as with LV mass (p=0,004) and VAC (p=0,05) in men, but not in women, Late-wave ratio (E/A) and the early mitral annular velocity (E wave) shown a significant negative correlation with PAC in men (p=0,049 and p=0,018 respectively), but not in women. Conclusion: PA levels, even within the normal range, may affect at early-stage LV efficiency, which was non-invasively evaluated thorughout the echocardiographic measurement of VAC. The discrepancies found in PRA correlations with ecocardiographic parameters according to gender, which may be due to a crosstalk between androgens and the cardiovascular effects of aldosterone, suggest the possible different susceptibility of the ventricle to aldosterone in women and men.