Photo Credit: Dr_Microbe

The following is a summary of “Role of aldosterone in various target organ damage in patients with hypertensive emergency: a cross-sectional study,” published in the October 2024 issue of Nephrology by Miyake et al. 

Hypertensive emergencies lead to multiple organ injuries, with RAS activation playing a key role. The link between RAS activation and organ damage remains unclear. 

Researchers conducted a retrospective study to explore the association between RAS activation and organ damage in patients with hypertensive emergencies. 

They enrolled 63 patients with acute severe hypertension and multiple organ damage who visited the medical center between 2012 and 2020. Hypertensive target organ damage was assessed on admission, including severe kidney impairment (SKI) (eGFR less than 30 mL/min/1.73 m², SKI), severe retinopathy, concentric left ventricular hypertrophy (c-LVH), thrombotic microangiopathy (TMA), heart failure with reduced ejection fraction (HFrEF), and cerebrovascular disease. They analyzed whether each organ injury was associated with blood pressure or plasma aldosterone concentration. 

The results showed that among 63 patients, 31 had SKI, 37 had severe retinopathy, 43 had c-LVH, and 8 had ischemic stroke. All groups with organ injuries, except cerebral infarction, had higher plasma aldosterone levels compared to others, though blood pressure varied. About 22 patients had a combination of SKI, severe retinopathy, and c-LVH, with 5 also exhibiting TMA. The number of damaged organs correlated with plasma aldosterone levels (Spearman’s coefficient = 0.50), and plasma aldosterone (≥ 250 pg/mL) was strongly linked to 3 or more complications (OR = 9.16 [95% CI: 2.76–30.35]). 

Investigators concluded that higher aldosterone levels contributed to organ damage development and were linked to the number of damaged organs in patients with hypertensive emergencies. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03769-7