{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T20:05:02Z","timestamp":1770581102284,"version":"3.49.0"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"05","funder":[{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"crossref","award":["RA-45913\/3-1, CRC\/TRR 205 \u201cThe Adrenal Gland\u201d"],"award-info":[{"award-number":["RA-45913\/3-1, CRC\/TRR 205 \u201cThe Adrenal Gland\u201d"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"name":"European Research Council under the European Union\u2019s Horizon 2020 research and innovation programme","award":["grant agreement No 694913"],"award-info":[{"award-number":["grant agreement No 694913"]}]},{"name":"Else Kr\u00f6ner-Fresenius Stiftung","award":["2012_A103, 2015_A228, 2019_A104"],"award-info":[{"award-number":["2012_A103, 2015_A228, 2019_A104"]}]},{"name":"German Center for Diabetes Research e.V."},{"DOI":"10.13039\/501100003107","name":"Federal Ministry of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003107","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Ministry of Culture and Science of the state North Rhine Westphalia"},{"name":"Virtual Diabetes Institute"},{"name":"German Federal Ministry of Education and Research"},{"name":"State of Bavaria"},{"name":"German Diabetes Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction Aldosterone excess is linked to cardiovascular events and\n                    mortality as well as to low-grade inflammation in the context of metabolic\n                    diseases. Whether mildly elevated aldosterone levels in the general population\n                    promote cardiovascular risk is still under debate. We analyzed the association\n                    of plasma aldosterone concentrations with incident cardiovascular events,\n                    cardiovascular and all-cause mortality as well as with biomarkers of subclinical\n                    inflammation in the population-based KORA F4 study.<\/jats:p><jats:p>\n          Methods Plasma aldosterone concentrations were measured with an in-house\n                    immunoflurometric assay. The analyses included 2935 participants (n=1076\n                    for selected biomarkers of subclinical inflammation) with a median follow-up of\n                    8.7 (8.2; 9.1) years. The associations were estimated using Cox proportional\n                    hazard and linear regression models adjusted for renin, sex, age, body mass\n                    index, arterial hypertension, diabetes, estimated glomerular filtration rate,\n                    low- and high-density lipoprotein cholesterol, physical activity, smoking, use\n                    of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers,\n                    beta-blockers, diuretics and calcium channel blockers.<\/jats:p><jats:p>\n          Results Aldosterone was significantly associated with all-cause mortality\n                    (hazard ratio per standard deviation increase: 1.20; 95% confidence\n                    interval 1.04\u20131.37), but not with cardiovascular mortality, incident\n                    cardiovascular events, or with biomarkers of subclinical inflammation.<\/jats:p><jats:p>\n          Conclusions Aldosterone was associated with all-cause mortality in the\n                    population-based KORA F4 study, but the previously described associations of\n                    excess aldosterone with cardiovascular complications and biomarkers of\n                    subclinical inflammation could not be shown.<\/jats:p>","DOI":"10.1055\/a-2035-6179","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T00:13:41Z","timestamp":1676420021000},"page":"307-313","source":"Crossref","is-referenced-by-count":3,"title":["Association of Aldosterone with Mortality in the General\n                    Population"],"prefix":"10.1055","volume":"131","author":[{"given":"Cornelia","family":"Then","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, University Hospital of\n                    Ludwig-Maximilians-University Munich, Germany"},{"name":"German Center for Diabetes Research (DZD), Partner Munich-Neuherberg,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Herder","sequence":"additional","affiliation":[{"name":"German Center for Diabetes Research (DZD), Partner D\u00fcsseldorf,\n                    Germany"},{"name":"Department of Endocrinology and Diabetology, Medical Faculty and\n                    University Hospital D\u00fcsseldorf, Heinrich-Heine-University\n                    D\u00fcsseldorf; Germany"},{"name":"Institute of Clinical Diabetology, German Diabetes Center, Leibniz\n                    Center for Diabetes Research at Heinrich-Heine-University D\u00fcsseldorf,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margit","family":"Heier","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology, Helmholtz Zentrum Munich \u2013 German\n                    Research Center for Environmental Health (GmbH), Neuherberg,\n                    Germany"},{"name":"KORA Study Centre, University Hospital Augsburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christa","family":"Meisinger","sequence":"additional","affiliation":[{"name":"Independent Research Group Clinical Epidemiology, Helmholtz Zentrum\n                    Munich \u2013 German Research Center for Environmental Health (GmbH),\n                    Neuherberg, Germany"},{"name":"Chair of Epidemiology, University Hospital Augsburg,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Koenig","sequence":"additional","affiliation":[{"name":"DZHK (German Centre for Cardiovascular Research), partner site Munich\n                    Heart Alliance, Munich, Germany"},{"name":"Institute of Epidemiology and Medical Biometry, University of Ulm,\n                    Germany"},{"name":"German Heart Center Munich, Technical University of Munich,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Rathmann","sequence":"additional","affiliation":[{"name":"German Center for Diabetes Research (DZD), Partner D\u00fcsseldorf,\n                    Germany"},{"name":"Institute of Biometrics and Epidemiology, German Diabetes Center,\n                    Leibniz Institute at Heinrich-Heine-University D\u00fcsseldorf,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaterina","family":"Sujana","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology, Helmholtz Zentrum Munich \u2013 German\n                    Research Center for Environmental Health (GmbH), Neuherberg,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Roden","sequence":"additional","affiliation":[{"name":"German Center for Diabetes Research (DZD), Partner D\u00fcsseldorf,\n                    Germany"},{"name":"Department of Endocrinology and Diabetology, Medical Faculty and\n                    University Hospital D\u00fcsseldorf, Heinrich-Heine-University\n                    D\u00fcsseldorf; Germany"},{"name":"Institute of Clinical Diabetology, German Diabetes Center, Leibniz\n                    Center for Diabetes Research at Heinrich-Heine-University D\u00fcsseldorf,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Bidlingmaier","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, University Hospital of\n                    Ludwig-Maximilians-University Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Seissler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, University Hospital of\n                    Ludwig-Maximilians-University Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Thorand","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology, Helmholtz Zentrum Munich \u2013 German\n                    Research Center for Environmental Health (GmbH), Neuherberg,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette","family":"Peters","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology, Helmholtz Zentrum Munich \u2013 German\n                    Research Center for Environmental Health (GmbH), Neuherberg,\n                    Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), partner site Munich\n                    Heart Alliance, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, University Hospital of\n                    Ludwig-Maximilians-University Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1016\/J.BBADIS.2010.08.005","article-title":"Aldosterone: A cardiovascular risk factor?","volume":"1802","author":"J W Funder","year":"2010","journal-title":"Biochim Biophys Acta"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1161\/CIRCULATIONAHA.106.653964","article-title":"Complementary and incremental mortality risk prediction by cortisol and\n                    aldosterone in chronic heart failure","volume":"115","author":"G G\u00fcder","year":"2007","journal-title":"Circulation"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1016\/S2213-8587(21)00210-2","article-title":"Diagnosis and treatment of primary aldosteronism","volume":"9","author":"M Reincke","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1161\/HYPERTENSIONAHA.112.197111","article-title":"Observational study mortality in treated primary aldosteronism: The German\n                    Conn\u2019s registry","volume":"60","author":"M Reincke","year":"2012","journal-title":"Hypertens (Dallas, Tex 1979)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/S2213-8587(17)30367-4","article-title":"Cardiometabolic outcomes and mortality in medically treated primary\n                    aldosteronism: A retrospective cohort study","volume":"6","author":"G L Hundemer","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1093\/eurheartj\/ehq019","article-title":"Plasma aldosterone levels are associated with increased cardiovascular\n                    mortality: The Ludwigshafen Risk and Cardiovascular Health (LURIC) study","volume":"31","author":"A Tomaschitz","year":"2010","journal-title":"Eur Heart J"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1093\/eurheartj\/ehr176","article-title":"Aldosterone, mortality, and acute ischaemic events in coronary artery disease\n                    patients outside the setting of acute myocardial infarction or heart\n                    failure","volume":"33","author":"F Ivanes","year":"2012","journal-title":"Eur Heart J"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1016\/J.IJCARD.2012.05.034","article-title":"Aldosterone, atherosclerosis and vascular events in patients with stable\n                    coronary artery disease","volume":"167","author":"M A Hillaert","year":"2013","journal-title":"Int J Cardiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1016\/J.AHJ.2008.12.013","article-title":"Aldosterone and long-term outcome after myocardial infarction: A substudy of the\n                    french nationwide Observatoire sur la Prise en charge hospitali\u00e8re,\n                    l\u2019Evolution \u00e0 un an et les caRact\u00e9ristiques de patients\n                    pr\u00e9sentant un infArctus du myocarde avec ou sans onde Q (OPERA)\n                    study","volume":"157","author":"F Beygui","year":"2009","journal-title":"Am Heart J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1056\/nejm199909023411001","article-title":"The effect of spironolactone on morbidity and mortality in patients with severe\n                    heart failure","volume":"341","author":"B Pitt","year":"1999","journal-title":"N Engl J Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/J.EJHEART.2005.11.008","article-title":"Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left\n                    ventricular ejection fraction","volume":"8","author":"B Pitt","year":"2006","journal-title":"Eur J Heart Fail"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1056\/NEJMOA030207","article-title":"Eplerenone, a selective aldosterone blocker, in patients with left ventricular\n                    dysfunction after myocardial infarction","volume":"348","author":"B Pitt","year":"2003","journal-title":"N Engl J Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2021","DOI":"10.1155\/2021\/1710731","article-title":"Aldosterone blockade in acute myocardial infarction: A systematic review and\n                    meta-analysis","author":"Q Chen","year":"2021","journal-title":"Cardiovasc Ther"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2559","DOI":"10.1161\/01.CIR.0000068340.96506.0F","article-title":"Immediate administration of mineralocorticoid receptor antagonist spironolactone\n                    prevents post-infarct left ventricular remodeling associated with suppression of\n                    a marker of myocardial collagen synthesis in patients with first anterior acute\n                    myocardial infarction","volume":"107","author":"M Hayashi","year":"2003","journal-title":"Circulation"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1161\/CIRCULATIONAHA.110.983023","article-title":"Deletion of cardiomyocyte mineralocorticoid receptor ameliorates adverse\n                    remodeling after myocardial infarction","volume":"123","author":"D Fraccarollo","year":"2011","journal-title":"Circulation"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1161\/JAHA.112.000018","article-title":"Aldosterone increases early atherosclerosis and promotes plaque inflammation\n                    through a placental growth factor-dependent mechanism","author":"A P McGraw","year":"2013","journal-title":"J Am Heart Assoc"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/J.IJCARD.2017.01.013","article-title":"Essential role of ICAM-1 in aldosterone-induced atherosclerosis","volume":"232","author":"V Marzolla","year":"2017","journal-title":"Int J Cardiol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1161\/CIRCRESAHA.108.174235","article-title":"Functional mineralocorticoid receptors in human vascular endothelial cells\n                    regulate intercellular adhesion molecule-1 expression and promote leukocyte\n                    adhesion","volume":"102","author":"M Caprio","year":"2008","journal-title":"Circ Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1093\/CVR\/CVY013","article-title":"IL-6 trans-signalling contributes to aldosterone-induced cardiac fibrosis","volume":"114","author":"C H Chou","year":"2018","journal-title":"Cardiovasc Res"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1210\/EN.2017-00651","article-title":"Inflammation and fibrosis in perirenal adipose tissue of patients with\n                    aldosterone-producing adenoma","volume":"159","author":"C Wu","year":"2018","journal-title":"Endocrinology"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1093\/AJH\/HPAA137","article-title":"Aldosterone, inflammation, immune system, and hypertension","volume":"34","author":"N S Ferreira","year":"2021","journal-title":"Am J Hypertens"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1007\/s10654-018-0475-8","article-title":"Protein markers and risk of type 2 diabetes and prediabetes: A targeted\n                    proteomics approach in the KORA F4\/FF4 study","volume":"34","author":"C Huth","year":"2019","journal-title":"Eur J Epidemiol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"335","DOI":"10.2147\/VHRM.S363814","article-title":"Association of C-terminal pro-endothelin-1 with mortality in the\n                    population-based KORA F4 Study","volume":"18","author":"C Then","year":"2022","journal-title":"Vasc Health Risk Manag"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1677\/JOE-07-0134","article-title":"A highly sensitive immunofluorometric assay for the measurement of aldosterone\n                    in small sample volumes: Validation in mouse serum","volume":"196","author":"J Manolopoulou","year":"2008","journal-title":"J Endocrinol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1016\/S0197-2456(00)00104-5","article-title":"Sample-size calculations for the Cox proportional hazards regression model with\n                    nonbinary covariates","volume":"21","author":"F Y Hsieh","year":"2000","journal-title":"Control Clin Trials"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1161\/HYPERTENSIONAHA.114.03936","article-title":"Circulating aldosterone and natriuretic peptides in the general community\n                    relationship to cardiorenal and metabolic disease","volume":"65","author":"A Buglioni","year":"2015","journal-title":"Hypertension"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1111\/cen.12615","article-title":"Lower aldosterone-renin ratio is a risk factor for total and cancer death in\n                    Japanese individuals: The Takahata study","volume":"82","author":"M Daimon","year":"2015","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1016\/j.metabol.2011.08.004","article-title":"Higher plasma renin activity is a risk factor for total mortality in older\n                    Japanese individuals: The Takahata study","volume":"61","author":"M Daimon","year":"2012","journal-title":"Metabolism"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1161\/HYPERTENSIONAHA.114.03311","article-title":"Serum aldosterone and death, end-stage renal disease, and cardiovascular events\n                    in blacks and whites: Findings from the chronic renal insufficiency cohort\n                    (CRIC) study","volume":"64","author":"R Deo","year":"2014","journal-title":"Hypertension"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1053\/J.AJKD.2010.10.047","article-title":"Association of plasma aldosterone with cardiovascular mortality in patients with\n                    low estimated GFR: the Ludwigshafen Risk and Cardiovascular Health (LURIC)\n                    Study","volume":"57","author":"A Tomaschitz","year":"2011","journal-title":"Am J Kidney Dis"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"3515","DOI":"10.1093\/EURHEARTJ\/EHT095","article-title":"Endothelial mineralocorticoid receptor activation mediates endothelial\n                    dysfunction in diet-induced obesity","volume":"34","author":"N Sch\u00e4fer","year":"2013","journal-title":"Eur Heart J"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1161\/CIRCRESAHA.115.308269","article-title":"Endothelial mineralocorticoid receptor mediates diet-induced aortic stiffness in\n                    females","volume":"118","author":"G Jia","year":"2016","journal-title":"Circ Res"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1007\/S00395-017-0643-0","article-title":"Long-term spironolactone treatment reduces coronary TRPC expression,\n                    vasoconstriction, and atherosclerosis in metabolic syndrome pigs","author":"W Li","year":"2017","journal-title":"Basic Res Cardiol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2694","DOI":"10.1161\/01.CIR.99.20.2694","article-title":"Activation of cardiac aldosterone production in rat myocardial infarction:\n                    Effect of angiotensin II receptor blockade and role in cardiac fibrosis","volume":"99","author":"J S Silvestre","year":"1999","journal-title":"Circulation"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1161\/01.CIR.103.1.72","article-title":"Aldosterone production is activated in failing ventricle in humans","volume":"103","author":"Y Mizuno","year":"2001","journal-title":"Circulation"}],"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2035-6179.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T23:26:15Z","timestamp":1684365975000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2035-6179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,14]]},"references-count":35,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2023,5,17]]},"published-print":{"date-parts":[[2023,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2035-6179","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"value":"0947-7349","type":"print"},{"value":"1439-3646","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,2,14]]},"published":{"date-parts":[[2023,2,14]]}}}