{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:48:49Z","timestamp":1792021729402,"version":"4.4.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Excess aldosterone of &amp;gt;15 ng\/dL, in the presence of low renin, is linked to hypertension (HTN) and chronic kidney disease (CKD). This study investigated the association of aldosterone dysregulation at lower plasma aldosterone levels (\u22655 ng\/dL) with the risk of uncontrolled HTN and CKD prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patient plasma aldosterone measurements obtained during 2013-2023 were identified in the TriNetX Dataworks-USA Network of electronic medical records. Eligible patients (\u226518 years) had a plasma renin activity measurement of \u22641 ng\/mL\/h within 12 months before, and a systolic blood pressure (SBP) measurement within 12 months following, the index aldosterone measurement. The primary outcome was uncontrolled HTN (SBP \u2265130 mmHg) prevalence. The secondary outcome was CKD prevalence (CKD diagnosis or eGFR measurement of &amp;lt;60 mL\/min\/1.73 m2). The adjusted odds ratio (aOR) of uncontrolled HTN during a 12-month follow-up was calculated among plasma aldosterone groups (\u22655 vs &amp;lt;5 ng\/dL, \u226510 vs &amp;lt;10 ng\/dL, and \u226515 vs &amp;lt;15 ng\/dL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients (N\u2009=\u20091334) had a mean age of 59 years, and 55.9% were female. Patients with plasma aldosterone of \u22655 ng\/dL (N\u2009=\u2009903) had a higher risk (aOR [95% CI]) of uncontrolled HTN (2.01 [1.38-2.92]; P\u2009&amp;lt;\u2009.001) versus &amp;lt;5 ng\/dL (N\u2009=\u2009431). Similar findings were observed for plasma aldosterone levels of \u226510 ng\/dL and \u226515 ng\/dL. Patients with plasma aldosterone of \u226510 ng\/dL (N\u2009=\u2009514) had a higher risk of CKD (1.49 [1.15-1.92]; P\u2009&amp;lt;\u2009.001) versus &amp;lt;10 ng\/dL (N\u2009=\u2009820). Similar findings were observed for plasma aldosterone levels of \u226515 ng\/dL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinically relevant aldosterone dysregulation, in the presence of low renin, occurs at lower aldosterone levels than previously thought, and remains significantly associated with uncontrolled HTN and CKD prevalence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpaf183","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T11:44:12Z","timestamp":1757159052000},"page":"161-170","source":"Crossref","is-referenced-by-count":9,"title":["Risk of Hypertension and Chronic Kidney Disease Following Aldosterone Dysregulation"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3215-9118","authenticated-orcid":false,"given":"Raymond R","family":"Townsend","sequence":"first","affiliation":[{"name":"Department of Renal Medicine, University of Pennsylvania School of Medicine , Philadelphia, PA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abiy","family":"Agiro","sequence":"additional","affiliation":[{"name":"US Medical Affairs, Biopharmaceuticals, AstraZeneca , Wilmington, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Luan","sequence":"additional","affiliation":[{"name":"US Medical Affairs, Biopharmaceuticals, AstraZeneca , Wilmington, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaylen","family":"Brzozowski","sequence":"additional","affiliation":[{"name":"TriNetX, LLC , Cambridge, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erick","family":"Moyneur","sequence":"additional","affiliation":[{"name":"Statlog Inc , Qu\u00e9bec,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paule","family":"Tetreault-Langlois","sequence":"additional","affiliation":[{"name":"Statlog Inc , Qu\u00e9bec,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Huang","sequence":"additional","affiliation":[{"name":"US Medical Affairs, Biopharmaceuticals, AstraZeneca , Wilmington, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"2026011413232069200_hpaf183-B1","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/S0140-6736(21)01330-1","article-title":"NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants","volume":"398","year":"2021","journal-title":"Lancet"},{"key":"2026011413232069200_hpaf183-B2","author":"MillionHearts","year":"2024"},{"key":"2026011413232069200_hpaf183-B3","doi-asserted-by":"crossref","first-page":"9418","DOI":"10.1038\/s41598-018-27377-2","article-title":"Uncontrolled hypertension increases risk of all-cause and cardiovascular disease mortality in US adults: the NHANES III Linked Mortality Study","volume":"8","author":"Zhou","year":"2018","journal-title":"Sci Rep"},{"key":"2026011413232069200_hpaf183-B4","author":"CDC Centers for Disease Control and Prevention (CDC)","year":"2024"},{"key":"2026011413232069200_hpaf183-B5","first-page":"1","article-title":"Mortality in the United States, 2021","volume":"2022","author":"Xu","year":"2022","journal-title":"NCHS Data 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