Cardiovascular Complications of Patients with Aldosteronism Associated with Autonomous Cortisol Secretion

Context: Primary aldosteronism (PA) is sometimes associated with the autonomous secretion of cortisol. Objective: Our objective was to investigate the effect of autonomous cortisol secretion on the prevalence of cardiovascular events (CVE) in patients with PA. Design: This was a retrospective cross-sectional study of cases collected from Gunma University Hospital between 2002 and 2010. Patients: Seventy-six consecutive patients hospitalized for an evaluation of PA were analyzed. Main Outcome Measures: Rates of CVE dependent on autonomous cortisol secretion were examined. Results: Of the 76 patients with PA, 21 (28%) had a history of CVE, including 14 with stroke, one with myocardial infarction, and six with atrial fibrillation. The multivariate logistic-regression and receiver operating characteristic analyses revealed that PA patients with CVE had significantly higher midnight cortisol levels than those without CVE; the adjusted odds ratio with a cutoff value of 7.4 μg/dl was 7.0 (95% confidence interval...