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. 2025 Mar 25:12:1549878.
doi: 10.3389/fcvm.2025.1549878. eCollection 2025.

Association of plasma aldosterone concentration with peripheral artery disease in hypertensive patients: insights from a large cross-sectional analysis

Yingying Zhang #  1   2   3 , Xintian Cai #  1   2   3 , Shuaiwei Song  1   2   3 , Junli Hu  1   2   3   4   5   6 , Pan Zhou  1   2   3 , Kangxin Cai  1   2   3 , Rui Ma  1   2   3 , Huimin Ma  1   2   3 , Di Shen  1   2   3 , Wenbo Yang  1   2   3 , Delian Zhang  1   2   3   4   5   6 , Qin Luo  1   2   3   4   5   6 , Jing Hong  1   2   3   4   5   6 , Nanfang Li  1   2   3   4   5   6
Affiliations

Association of plasma aldosterone concentration with peripheral artery disease in hypertensive patients: insights from a large cross-sectional analysis

Yingying Zhang et al. Front Cardiovasc Med. .

Abstract

Objectives: To investigate the relationship between plasma aldosterone concentration (PAC) and the prevalence of peripheral artery disease (PAD) in hypertensive patients and to determine any potential threshold effects.

Methods: This cross-sectional study analyzed data from 13,157 hypertensive individuals from the People's Hospital of Xinjiang Uygur Autonomous Region, China. PAD was diagnosed based on an ankle-brachial index (ABI) of ≤0.90. A multivariate logistic regression model was utilized to evaluate the association between PAC and PAD, and a generalized additive model (GAM) was employed to explore non-linear relationships.

Results: The fully adjusted logistic regression model revealed a significant positive association between PAC and PAD, with an odds ratio (OR) [95% confidence interval (CI)] of 1.06 (1.04, 1.08) per unit increase in PAC. The GAM identified a critical threshold at 17.00 ng/dl for PAC, above which the prevalence of PAD increased by 9% for each unit increase in PAC, with an OR (95% CI) of 1.09 (1.06, 1.11). Sensitivity and subgroup analyses confirmed the robustness of these findings.

Conclusion: This study establishes a non-linear relationship between PAC and the prevalence of PAD in hypertensive patients, with a critical threshold at 17.00 ng/dl. These findings underscore the importance of aldosterone homeostasis in vascular health and the need for further large-scale, prospective studies to validate these results and explore their clinical implications.

Keywords: ankle-brachial index; cross-sectional study; hypertension; non-linear relationship; peripheral vascular disease; plasma aldosterone concentration.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of study participants.
Figure 2
Figure 2
Bar chart represented the prevalence of PAD across different tertiles of PAC.
Figure 3
Figure 3
Generalized additive model were performed to examine the shape of the associations between PAC and the prevalence of PAD. Age, sex, smoking state, drinking state, diabetes, coronary heart disease, hyperlipidemia, BMI, SBP, DBP, FPG, HDL-C, LDL-C, TC, TG, SUA, BUN, Scr, AST/ALT, Hcy, K+, ACEIs/ARBs, beta blockers, calcium channel blockers, diuretics, lipid-lowering drugs, antidiabetic drugs, antiplatelet drugs were adjusted.
See this image and copyright information in PMC

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