{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:44:27Z","timestamp":1792183467771,"version":"4.4.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The loss of physiological nocturnal blood pressure (BP) decline is a major contributor to cardiovascular risk, yet its endocrine underpinnings in primary aldosteronism (PA) remain underexplored. This study aimed to elucidate the dose\u2010dependent relationship between aldosterone excess and circadian BP rhythm disruption and assess whether targeted aldosterone suppression could ameliorate nocturnal dipping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We prospectively analyzed 24\u2010hour ambulatory BP data from 681 patients with confirmed PA, stratified by plasma aldosterone concentration. A subset of 99 patients with adrenal vein sampling\u2013confirmed unilateral PA received targeted, minimally invasive vascular intervention for aldosterone suppression and were evaluated for changes in BP rhythm on the basis of treatment response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In multivariable\u2010adjusted models, both log\u2010transformed plasma aldosterone concentration and aldosterone\u2010to\u2010renin ratio were inversely associated with the proportion of nocturnal systolic BP decline (log plasma aldosterone concentration: \u03b2=\u22120.054 [95% CI, \u22120.087 to \u22120.020];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002; log aldosterone\u2010to\u2010renin ratio: \u03b2=\u22120.016 [95% CI, \u22120.025 to \u22120.006];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.001). In patients achieving biochemical remission after selective suppression, nighttime systolic BP decreased significantly (mean reduction=\u221233\u2009mm\u2009Hg; Cohen\u2019s d_z=2.113). The prevalence of the dipper pattern increased from 14.5% to 39.1% (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), while no rhythm improvement was observed in nonresponders. Multivariable regression confirmed biochemical success as an independent predictor of nocturnal dip amelioration (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.045), irrespective of adrenal imaging phenotype.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Aldosterone excess contributes directly to circadian BP rhythm disruption in PA. Selective hormonal suppression can ameliorate physiological BP dipping in responsive patients. These findings highlight the value of rhythm\u2010based end points and support aldosterone\u2010targeted modulation as a strategic goal in PA management.<\/jats:p>\n                    <jats:p xml:lang=\"en\">\n                      Registration: URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\/\">https:\/\/www.chictr.org.cn\/<\/jats:ext-link>\n                      ; Unique Identifier: ChiCTR2200057297.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.044976","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:34:35Z","timestamp":1773138875000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Aldosterone and Impaired Nocturnal Blood Pressure Decline in Primary Aldosteronism"],"prefix":"10.1161","volume":"15","author":[{"given":"Ning\u2010Peng","family":"Liang","sequence":"first","affiliation":[{"name":"Nanchang University","place":["China"]},{"name":"The Second Affiliated Hospital of Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Li","sequence":"additional","affiliation":[{"name":"Nanchang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Wu","sequence":"additional","affiliation":[{"name":"Nanchang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi\u2010Xin","family":"Lin","sequence":"additional","affiliation":[{"name":"Nanchang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zai\u2010jia","family":"Wang","sequence":"additional","affiliation":[{"name":"Nanchang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4682-7107","authenticated-orcid":false,"given":"Chen\u2010Guang","family":"Wu","sequence":"additional","affiliation":[{"name":"Nanchang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2799-5031","authenticated-orcid":false,"given":"Hong\u2010Liang","family":"Xiong","sequence":"additional","affiliation":[{"name":"Nanchang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Yang","sequence":"additional","affiliation":[{"name":"Nanchang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6290-1491","authenticated-orcid":false,"given":"Yi\u2010Fei","family":"Dong","sequence":"additional","affiliation":[{"name":"Nanchang University","place":["China"]},{"name":"The Second Affiliated Hospital of Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.124.24026"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e328172dc2e"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004847"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.016299"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","unstructured":"Kario K Hoshide S Chia YC Buranakitjaroen P Siddique S Shin J Turana Y Park S Tsoi K Chen CH et\u00a0al. Guidance on ambulatory blood pressure monitoring: a statement from the HOPE Asia network. 2021;23:411\u2013421. doi: 10.1111\/jch.14128","DOI":"10.1111\/jch.14128"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.33549\/physiolres.930042"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03349173"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-021-02606-3"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-006-0968-3"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30367-4"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11568"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2009.11.020"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.123.22281"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2272011798"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-023-01236-8"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.054318"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-022-01034-8"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/jch.13960"},{"key":"e_1_3_2_20_2","first-page":"12","article-title":"Expert consensus on the diagnosis and treatment of primary aldosteronism (2024 edition) in chinese","volume":"41","author":"Chinese Society of Endocrinology","year":"2025","unstructured":"Chinese Society of Endocrinology . Expert consensus on the diagnosis and treatment of primary aldosteronism (2024 edition) in chinese. Chin J Endocrinol Metab. 2025;41:12\u201324.","journal-title":"Chin J Endocrinol Metab"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpaf083"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-023-01503-8"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30135-3"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2009.9"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.115.06981"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-023-01325-8"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.653303"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)02755-7"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.38209"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejendo\/lvaf118"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.044976","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:13:00Z","timestamp":1782990780000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.044976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,3,17]]}},"alternative-id":["10.1161\/JAHA.125.044976"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.044976","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"2025-07-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e044976"}}