Table 1.
Summary of clinical studies on primary aldosteronism and endothelial dysfunction.
| Author and Year | Assessment Method | Study Group | Control Group | Treatment | Change and Effect on Endothelial Function |
|---|---|---|---|---|---|
| Biomarker | |||||
| Verhovez et al. (2008) [129] | Biomarkers: EPC | PA | Healthy control | - | No difference between high aldosterone treated EPCs with healthy EPCs |
| Thum et al. (2011) [130] | Biomarkers: EPC PAT |
PA | Healthy control Mouse EPCs |
Spironolactone | EPCs from PA showed reduced migratory potential and reduced RHI. EPCs treated with aldosterone in vitro showed impaired multiple cellular functions through MR-dependent pathway. |
| Wu et al. (2011) [131] | Biomarkers: EPC PWV |
PA | EH | Adrenalectomy or spironolactone | Decreased circulating EPCs and endothelial CFUs, improved after treatment |
| Matrozova et al. (2016) [161] | Biomarkers: ADMA | PA | EH and healthy control | - | No difference between PA and EH |
| Liu et al. (2014) [162] | Biomarkers: vWF | PA | EH | - | Increased |
| Biomarkers: ICAM-1 | PA | EH | - | Increased | |
| Biomarkers: ox-LDL | PA | EH | - | Increased | |
| Chou et al. (2018) [104] | Biomarkers: IL-6 | PA | EH | Adrenalectomy | Elevated IL-6 among PA using mineralocorticoid receptor/PI3K/Akt/NF-kB pathway |
| FMD/PAT | |||||
| Nishizaka et al. (2004) [163] | FMD + NMD | Resistant hypertension with hyperaldosteronism | Resistant hypertension without hyperaldosteronism | Spironolactone | Resistant hypertension with hyperaldosteronism showed lower FMD and improved after spironolactone. |
| Lai et al. (2016) [164] | FMD | ADPKD with PA | ADPKD without PA | - | ADPKD with PA shows lower FMD. |
| Chou et al. (2015) [165] | FMD + NMD | PA | EH | - | FMD and NMD are both decreased in PA SERCA2a suppression is observed in vascular smooth muscle. |
| Matsumoto et al. (2015) [55] | FMD + NMD | APA IHA |
EH | Adrenalectomy on APA | FMD lower in APA than IHA and EH NMD no significant difference |
| Kishimoto et al. (2018) [166] | FMD + NMD PAT |
APA IHA |
EH | - | FMD lower in APA NMD lower in APA RHI lower in APA and IHA than EH. |
| Kishimoto et al. (2019) [56] | FMD + NMD PAT PWV |
IHA | - | Eplerenone | RHI, NMD improved. PWV, ROCK activity decreased. No change in FMD and IMT. |
| Chang et al. (2015) [167] | PAT | PA | EH | - | PA had significantly higher AI but not RHI than EH |
| PWV | |||||
| Bernini et al. (2008) [168] | PWV | PA | EH and normotensives | - | PA showed more dysfunction and thicker IMT than EH and normotensives. |
| Strauch et al. (2006) [169] | PWV | PA | EH and normotensives | - | PA showed more dysfunction than EH and normotensives. |
| Strauch et al. (2008) [170] | PWV | PA receiving adrenalectomy | PA receiving spironolactone | Adrenalectomy or spironolactone | Endothelial dysfunction improved after adrenalectomy; not seen in spironolactone. |
| Rosa et al. (2012) [171] | PWV | PA | EH | - | PA showed more dysfunction |
| Wu et al. (2011) [131] | PWV | PA | EH | Adrenalectomy or spironolactone | Increased PWV in PA |
| Lin et al. (2012) [11] | PWV | APA | EH | Adrenalectomy | IMT and dysfunction improved after operation |
| Liao et al. (2016) [12] | PWV | APA | - | Adrenalectomy | Dysfunction improved after operation |
| Chang et al. (2017) [172] | PWV | APA with KCNJ5 (+) | APA with KCNJ5 (−) | Adrenalectomy | - |
PA = primary aldosteronism; EH = essential hypertension; APA = aldosterone-producing adenoma; IHA = idiopathic hyperaldosteronism; EPC = endothelial progenitor cells; PAT = peripheral arterial tonometry; PWV = pulse wave velocity; CFUs = colony forming units; ADMA = asymmetric dimethylarginine; vWF = von Willebrand factor; ICAM = intercellular adhesion molecule; ox-LDL = oxidized low-density lipoprotein; IL = interleukin; FMD = flow-mediated vasodilation; NMD = nitrate-mediated dilation; ADPKD = autosomal dominant polycystic kidney disease; SERCA = sarco/endoplasmic reticulum calcium ATPase; IMT = carotid intima-media thickness; AI = augmentation index; RHI = reactive hyperemic index and KCNJ5 = potassium voltage-gated channel subfamily J member 5.