Objective:

To synthesize available evidence linking renin suppression and mild aldosterone excess to cardiovascular outcomes.

Approach:

Key Findings:

• Suppressed renin and higher aldosterone levels, even within conventionally normal ranges, are associated with incident hypertension, left ventricular hypertrophy, atrial fibrillation, and cardiovascular events.
• In overt primary aldosteronism, significantly higher rates of cardiovascular diseases have been observed compared to blood pressure-matched essential hypertension.
• Emerging population-based data suggest a graded cardiovascular risk extending below traditional diagnostic thresholds.

Interpretation:

Biochemical phenotypes consistent with subclinical primary aldosteronism may represent an early cardiometabolic state associated with elevated risk of major adverse cardiovascular events, even before overt primary aldosteronism criteria are met.

Limitations:

• Absence of standardized diagnostic thresholds.
• Lack of randomized interventional data.

Conclusion:

Prospective trials evaluating renin-guided screening and early mineralocorticoid receptor antagonism are needed to determine whether intervention at the subclinical stage reduces long-term cardiovascular harm.

Source

Based on findings from:

Subclinical primary aldosteronism and major adverse cardiovascular events: evidence for a continuum of renin-independent aldosterone excess and a proposal for early detection

Atef Akoum, Mounir Hakim, Rola Kwayess, Bahaa El Deen Wehbeh, Lina Alaaeddine, Mohamed Nasser El Shabrawi, Ashesh Das, Akshay Kumar, Sreekant Avula, Abdallah Rebeiz, Jason Li. Frontiers In Cardiovascular Medicine, 2026.

https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2026.1826678/full

Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.