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In this study, we aimed to investigate whether PA is causally associated with CVD risk and cardiac magnetic resonance (CMR) parameters using the Mendelian randomization (MR) method. Independent and genome\u2010wide significant single nucleotide polymorphisms for PA were extracted from genome\u2010wide association study (GWAS) summary statistics. Genetic associations with the CVDs and CMR parameters were obtained from recent large\u2010scale GWASs or genetic consortia. Inverse\u2010variance weighted (IVW) method was utilized for the preliminary estimates, and multiple sensitivity analyses (including weighted median, Cochran's Q test, MR\u2010Egger, MR\u2010PRESSO, and leave\u2010one\u2010out analysis) were conducted to verify the robustness of the results. The MR analyses using the IVW method showed that genetically predicated PA was significantly associated with atrial fibrillation (OR = 1.046, 95% CI: 1.029\u20131.062, padj\u00a0&lt;\u00a00.001), myocardial infarction (OR = 1.029, 95% CI: 1.005\u20131.053, padj = 0.027), heart failure (OR = 1.023, 95% CI: 1.004\u20131.042, padj = 0.027), any stroke (OR = 1.062, 95% CI: 1.031\u20131.095, padj\u00a0&lt;\u00a00.001), any ischemic stroke (OR = 1.058, 95% CI: 1.022\u20131.095, padj = 0.004), and small vessel stroke (OR = 1.116, 95% CI: 1.041\u20131.196, padj = 0.004). Notably, PA also had a causal effect on adverse cardiac remodeling, including larger ventricular and atrial volumes, higher ventricular stroke volume, and reduced left atrial emptying fraction. Our findings support a causal role of PA in higher cardiovascular disease risk and adverse cardiac remodeling. Given the diagnostic delay and disease burden in PA, more attention should be paid to the screening and treatment of PA to reduce the incidence of cardiovascular outcomes.<\/jats:p>","DOI":"10.1111\/jch.14912","type":"journal-article","created":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T13:44:24Z","timestamp":1728308664000},"page":"1301-1309","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Primary Aldosteronism Influences Cardiac Structure, Function, and Disease Risk: Evidence From Mendelian Randomization Analysis"],"prefix":"10.1111","volume":"26","author":[{"given":"Rui","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Cardiology Union Hospital Tongji Medical College Huazhong University of Science and Technology  Wuhan China"},{"name":"Hubei Key Laboratory of Biological Targeted Therapy Union Hospital Tongji Medical College Huazhong University of Science and Technology  Wuhan 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