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Aldosteronism is associated with more severe cerebral small vessel disease in hypertensive intracerebral hemorrhage

Hypertension Research volume 47, pages 608–617 (2024)Cite this article

A Comment to this article was published on 22 November 2023

Abstract

Primary aldosteronism is associated with various types of cardiovascular and cerebrovascular damage independently of hypertension. Although chronic hypertension and related cerebral arteriosclerosis are the main risk factors for intracerebral hemorrhage, the effects of aldosteronism remain poorly understood. We enrolled 90 survivors of hypertensive intracerebral hemorrhage, 21 of them with aldosteronism and 69 with essential hypertension as controls in this study. Clinical parameters and neuroimaging markers of cerebral small vessel disease were recorded, and its correlations with aldosteronism were investigated. Our results showed that the aldosteronism group (55.2 ± 9.7 years, male 47.6%) had similar hypertension severity but exhibited a higher cerebral microbleed count (interquartile range) (8.5 [2.0‒25.8] vs 3 [1.0‒6.0], P = 0.005) and higher severity of dilated perivascular space in the basal ganglia (severe perivascular space [number >20], 52.4% vs. 24.6%, P = 0.029; large perivascular space [>3 mm], 52.4% vs. 20.3%, P = 0.010), compared to those with essential hypertension (53.8 ± 11.7 years, male 73.9%). In multivariate models, aldosteronism remained an independent predictor of a higher (>10) microbleed count (odds ratio = 8.60, P = 0.004), severe perivascular space (odds ratio = 4.00, P = 0.038); the aldosterone-to-renin ratio was associated with dilated perivascular space (P = 0.043) and large perivascular space (P = 0.008). In conclusions, survivors of intracerebral hemorrhage with aldosteronism showed a tendency towards more severe hypertensive arteriopathy than the essential hypertension counterparts independently of blood pressure; aldosteronism may contribute to dilated perivascular space around the deep perforating arteries.

Aldosteronism is associated with more severe cerebral small vessel disease in hypertensive intracerebral hemorrhage.

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Download references

TAIPAI study group

Vin-Cent Wu12, Tai-Shuan Lai12, Shih-Chieh Jeff Chueh12, Shao-Yu Yang12, Kao-Lang Liu12, Chin-Chen Chang12, Bo-Ching Lee12, Shuo-Meng Wang12, Kuo-How Huang12, Po-Chih Lin12, Yen-Hung Lin12, Chi-Sheng Hung12, Lian-Yu Lin12, Shih-Cheng Liao12, Ching-Chu Lu12, Chieh-Kai Chan12, Leay-Kiaw Er13, Ya-Hui Hu13, Che-Hsiung Wu13, Yao-Chou Tsai13, Zheng-Wei Chen14, Chien-Ting Pan14, Che-Wei Liao10, Cheng-Hsuan Tsai15, Yi-Yao Chang16, Chen-Hsun Ho17, Wei-Chieh Huang18, Ying-Ying Chen19

Funding

Funding

This work was supported by grants from the National Taiwan University Hospital (Lee BC, 109–004687) and Ministry of Science and Technology of Taiwan (111–2314-B-002–250-MY2).

Author information

Authors and Affiliations

  1. Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan, ROC

    Bo-Ching Lee, Chin-Chen Chang & Jia-Zheng Huang

  2. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, ROC

    Bo-Ching Lee, Zheng-Wei Chen, Yi-Yao Chang & Cheng-Hsuan Tsai

  3. Department of Medical Imaging, National Taiwan University Hospital Yun-lin Branch, Douliu, Taiwan, ROC

    Bo-Ching Lee

  4. Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan, ROC

    Hsin-Hsi Tsai & Li-Kai Tsai

  5. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC

    Zheng-Wei Chen, Yi-Yao Chang, Cheng-Hsuan Tsai, Vin-Cent Wu, Chi-Sheng Hung & Yen-Hung Lin

  6. Department of Internal Medicine, National Taiwan University Hospital Yun-lin Branch, Douliu, Taiwan, ROC

    Zheng-Wei Chen & Chien-Ting Pan

  7. Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC

    Yi-Yao Chang

  8. Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan, ROC

    Chia-Hung Chou

  9. Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, HsinChu, Taiwan, ROC

    Che-Wei Liao

  10. National Taiwan University Cancer Center, Taipei, Taiwan, ROC

    Che-Wei Liao & Che-Wei Liao

  11. Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan, ROC

    Chi-Sheng Hung & Yen-Hung Lin

  12. National Taiwan University Hospital, Taipei, Taiwan, ROC

    Vin-Cent Wu, Tai-Shuan Lai, Shih-Chieh Jeff Chueh, Shao-Yu Yang, Kao-Lang Liu, Chin-Chen Chang, Bo-Ching Lee, Shuo-Meng Wang, Kuo-How Huang, Po-Chih Lin, Yen-Hung Lin, Chi-Sheng Hung, Lian-Yu Lin, Shih-Cheng Liao, Ching-Chu Lu & Chieh-Kai Chan

  13. Taipei Tzu-Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan, ROC

    Leay-Kiaw Er, Ya-Hui Hu, Che-Hsiung Wu & Yao-Chou Tsai

  14. National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan, ROC

    Zheng-Wei Chen & Chien-Ting Pan

  15. National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan, ROC

    Cheng-Hsuan Tsai

  16. Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC

    Yi-Yao Chang

  17. Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC

    Chen-Hsun Ho

  18. Taipei Veterans General Hospital, Taipei, Taiwan, ROC

    Wei-Chieh Huang

  19. MacKay Memorial Hospital, Taipei, Taiwan, ROC

    Ying-Ying Chen

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  1. Bo-Ching Lee
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Consortia

TAIPAI study group

  • Vin-Cent Wu
  • , Tai-Shuan Lai
  • , Shih-Chieh Jeff Chueh
  • , Shao-Yu Yang
  • , Kao-Lang Liu
  • , Chin-Chen Chang
  • , Bo-Ching Lee
  • , Shuo-Meng Wang
  • , Kuo-How Huang
  • , Po-Chih Lin
  • , Yen-Hung Lin
  • , Chi-Sheng Hung
  • , Lian-Yu Lin
  • , Shih-Cheng Liao
  • , Ching-Chu Lu
  • , Chieh-Kai Chan
  • , Leay-Kiaw Er
  • , Ya-Hui Hu
  • , Che-Hsiung Wu
  • , Yao-Chou Tsai
  • , Zheng-Wei Chen
  • , Chien-Ting Pan
  • , Che-Wei Liao
  • , Cheng-Hsuan Tsai
  • , Yi-Yao Chang
  • , Chen-Hsun Ho
  • , Wei-Chieh Huang
  •  & Ying-Ying Chen

Contributions

B-CL project concept and design, data collection, imaging analysis, data analysis, write up. H-HT project concept and design, imaging analysis. Z-WC project concept and design, critical revisions. C-CC project concept and design. L-KT project concept and design. J-ZH data collection, imaging analysis. Y-YC project concept and design. C-HT project concept and design. C-HC critical revisions. C-WL critical revisions. C-TP critical revisions. C-SH critical revisiśons. V-CW project concept and design, data collection, critical revisions. Y-HL project concept and design, data collection, imaging analysis, critical revisions.

Corresponding authors

Correspondence to Li-Kai Tsai or Yen-Hung Lin.

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Lee, BC., Tsai, HH., Chen, ZW. et al. Aldosteronism is associated with more severe cerebral small vessel disease in hypertensive intracerebral hemorrhage. Hypertens Res 47, 608–617 (2024). https://doi.org/10.1038/s41440-023-01458-w

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