{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:16:43Z","timestamp":1784557003795,"version":"3.55.0"},"reference-count":32,"publisher":"Bioscientifica","issue":"12","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ec.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10,20]]},"abstract":"<jats:p>We applied 24-h Holter monitoring to analyze the characteristics of arrhythmias and heart rate variability in Chinese patients with primary aldosteronism (PA) and compared them with age-, sex-, and blood pressure-matched primary hypertension (PH) patients. A total of 216 PA patients and 261 PH patients were enrolled. The nonstudy data were balanced using propensity score matching (PSM), and the risk variables for developing arrhythmias were then analyzed using logistic regression analysis. Before PSM, the proportion of PA patients with combined atrial premature beats and prolonged QT interval was higher than the corresponding proportion in the PH group. After PSM, the PA group had a larger percentage of transient atrial tachycardia and frequent atrial premature beats, and it had higher heart rate variability metrics. The proportion of unilateral PA combined with multiple ventricular premature beats was higher than that of bilateral PA. Older age, grade 3 hypertension, and hypokalemia were independent risk factors for the emergence of arrhythmias in PA patients. PA patients suffer from a greater prevalence of arrhythmias than well-matched PH patients.<\/jats:p>","DOI":"10.1530\/ec-23-0359","type":"journal-article","created":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T10:11:50Z","timestamp":1697796710000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics of cardiac arrhythmia and heart rate variability in Chinese patients with primary aldosteronism"],"prefix":"10.1530","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3112-6719","authenticated-orcid":true,"given":"Shuang","family":"Wan","sequence":"first","affiliation":[{"name":"Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China"},{"name":"Department of Endocrinology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Zheng","sequence":"additional","affiliation":[{"name":"Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8371-779X","authenticated-orcid":true,"given":"Tao","family":"Chen","sequence":"additional","affiliation":[{"name":"Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Tan","sequence":"additional","affiliation":[{"name":"Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Tang","sequence":"additional","affiliation":[{"name":"Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoming","family":"Tian","sequence":"additional","affiliation":[{"name":"Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4519-397X","authenticated-orcid":true,"given":"Yan","family":"Ren","sequence":"additional","affiliation":[{"name":"Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Journal of the American College of Cardiology","first-page":"1811","article-title":"Prevalence and clinical manifestations of primary aldosteronism encountered in primary care practice","volume":"69","author":"Monticone","year":"2017","unstructured":"Monticone SBurrello JTizzani DBertello CViola ABuffolo FGabetti LMengozzi GWilliams TARabbia F, Prevalence and clinical manifestations of primary aldosteronism encountered in primary care practice. Journal of the American College of Cardiology2017691811\u20131820. (https:\/\/doi.org\/10.1016\/j.jacc.2017.01.052)"},{"key":"bib2","series-title":"Medicine (Baltimore)","first-page":"e15985","article-title":"Cardiovascular risk in primary aldosteronism: a systematic review and meta-analysis","volume":"98","author":"Wu","year":"2019","unstructured":"Wu XYu J & Tian H. Cardiovascular risk in primary aldosteronism: a systematic review and meta-analysis. Medicine (Baltimore)201998e15985. (https:\/\/doi.org\/10.1097\/MD.0000000000015985)"},{"key":"bib3","series-title":"Journal of Hypertension","first-page":"1919","article-title":"Genetics, prevalence, screening and confirmation of primary aldosteronism: a position statement and consensus of the working group on endocrine hypertension of the European Society of Hypertension","volume":"38","author":"Mulatero","year":"2020","unstructured":"Mulatero PMonticone SDeinum JAmar LPrejbisz AZennaro MCBeuschlein FRossi GPNishikawa TMorganti A, Genetics, prevalence, screening and confirmation of primary aldosteronism: a position statement and consensus of the working group on endocrine hypertension of the European Society of Hypertension. Journal of Hypertension2020381919\u20131928. (https:\/\/doi.org\/10.1097\/HJH.0000000000002510)"},{"key":"bib4","series-title":"European Journal of Cardio-Thoracic Surgery","first-page":"1112","article-title":"Statistical primer: propensity score matching and its alternatives","volume":"53","author":"Benedetto","year":"2018","unstructured":"Benedetto UHead SJAngelini GD & Blackstone EH. Statistical primer: propensity score matching and its alternatives. European Journal of Cardio-Thoracic Surgery2018531112\u20131117. (https:\/\/doi.org\/10.1093\/ejcts\/ezy167)"},{"key":"bib5","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"1889","article-title":"The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline","volume":"101","author":"Funder","year":"2016","unstructured":"Funder JWCarey RMMantero FMurad MHReincke MShibata HStowasser M & Young WFJr. The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism20161011889\u20131916. (https:\/\/doi.org\/10.1210\/jc.2015-4061)"},{"key":"bib6","series-title":"Journal of Hypertension","first-page":"1874","article-title":"ESH guidelines for the management of arterial hypertension the task force for the management of arterial hypertension of the european society of hypertension endorsed by the european renal association (ERA) and the international society of hypertension (Ish)","author":"Brunstr\u00f6m","year":"2023","unstructured":"Brunstr\u00f6m MBurnier MGrassi GJanuszewicz AMuiesan MLTsioufis KAgabiti-Rosei EAlgharably EAEAzizi MBenetos A, ESH guidelines for the management of arterial hypertension the task force for the management of arterial hypertension of the european society of hypertension endorsed by the european renal association (ERA) and the international society of hypertension (Ish). Journal of Hypertension2023411874\u20132071. (https:\/\/doi.org\/10.1097\/hjh.0000000000003480)"},{"key":"bib7","series-title":"Hypertension","first-page":"151","article-title":"An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism","volume":"63","author":"Rossi","year":"2014","unstructured":"Rossi GPAuchus RJBrown MLenders JWNaruse MPlouin PFSatoh F & Young WF. An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension201463151\u2013160. (https:\/\/doi.org\/10.1161\/HYPERTENSIONAHA.113.02097)"},{"key":"bib8","series-title":"Circulation","first-page":"3169","article-title":"Acc\/aha clinical competence statement on electrocardiography and ambulatory electrocardiography: a report of the acc\/aha\/acp-asim task force on clinical competence (acc\/aha committee to develop a clinical competence statement on electrocardiography and ambulatory electrocardiography) endorsed by the international society for holter and noninvasive electrocardiology","volume":"104","author":"Kadish","year":"2001","unstructured":"Kadish AHBuxton AEKennedy HLKnight BPMason JWSchuger CDTracy CMWinters WLJrBoone AWElnicki M, Acc\/aha clinical competence statement on electrocardiography and ambulatory electrocardiography: a report of the acc\/aha\/acp-asim task force on clinical competence (acc\/aha committee to develop a clinical competence statement on electrocardiography and ambulatory electrocardiography) endorsed by the international society for holter and noninvasive electrocardiology. Circulation20011043169\u20133178. (https:\/\/doi.org\/10.1161\/circ.104.25.3169)"},{"key":"bib9","series-title":"Lancet. Diabetes and Endocrinology","first-page":"41","article-title":"Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis","volume":"6","author":"Monticone","year":"2018","unstructured":"Monticone SD'Ascenzo FMoretti CWilliams TAVeglio FGaita F & Mulatero P. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis. Lancet. Diabetes and Endocrinology2018641\u201350. (https:\/\/doi.org\/10.1016\/S2213-8587(1730319-4)"},{"key":"bib10","series-title":"Journal of the American College of Cardiology","first-page":"1243","article-title":"Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism","volume":"45","author":"Milliez","year":"2005","unstructured":"Milliez PGirerd XPlouin PFBlacher JSafar ME & Mourad JJ. Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism. Journal of the American College of Cardiology2005451243\u20131248. (https:\/\/doi.org\/10.1016\/j.jacc.2005.01.015)"},{"key":"bib11","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"1125","article-title":"Cardiovascular and cerebrovascular comorbidities of hypokalemic and normokalemic primary aldosteronism: results of the German conn's registry","volume":"94","author":"Born-Frontsberg","year":"2009","unstructured":"Born-Frontsberg EReincke MRump LCHahner SDiederich SLorenz RAllolio BSeufert JSchirpenbach CBeuschlein F, Cardiovascular and cerebrovascular comorbidities of hypokalemic and normokalemic primary aldosteronism: results of the German conn's registry. Journal of Clinical Endocrinology and Metabolism2009941125\u20131130. (https:\/\/doi.org\/10.1210\/jc.2008-2116)"},{"key":"bib12","series-title":"European Journal of Preventive Cardiology","first-page":"694","article-title":"Primary aldosteronism and thyroid disorders in atrial fibrillation: a Swedish nationwide case-control study","volume":"25","author":"Mourtzinis","year":"2018","unstructured":"Mourtzinis GAdamsson Eryd SRosengren ABjorck LAdiels MJohannsson G & Manhem K. Primary aldosteronism and thyroid disorders in atrial fibrillation: a Swedish nationwide case-control study. European Journal of Preventive Cardiology201825694\u2013701. (https:\/\/doi.org\/10.1177\/2047487318759853)"},{"key":"bib13","series-title":"Journal of Hypertension","first-page":"332","article-title":"Atrial fibrillation as presenting sign of primary aldosteronism: results of the prospective appraisal on the prevalence of primary aldosteronism in hypertensive (papphy) study","volume":"38","author":"Seccia","year":"2020","unstructured":"Seccia TMLetizia CMuiesan MLLerco SCesari MBisogni VPetramala LMaiolino GVolpin R & Rossi GP. Atrial fibrillation as presenting sign of primary aldosteronism: results of the prospective appraisal on the prevalence of primary aldosteronism in hypertensive (papphy) study. Journal of Hypertension202038332\u2013339. (https:\/\/doi.org\/10.1097\/HJH.0000000000002250)"},{"key":"bib14","series-title":"Journal of Human Hypertension","first-page":"757","article-title":"Associated factors and effects of comorbid atrial fibrillation in hypertensive patients due to primary aldosteronism","volume":"37","author":"Sakaguchi","year":"2023","unstructured":"Sakaguchi SOkamoto RInoue CAkao MKamemura KKurihara ITakeda YOhno YInagaki NRakugi H, Associated factors and effects of comorbid atrial fibrillation in hypertensive patients due to primary aldosteronism. Journal of Human Hypertension202337757\u2013766. (https:\/\/doi.org\/10.1038\/s41371-022-00753-2)"},{"key":"bib15","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"4826","article-title":"Long-term cardio- and cerebrovascular events in patients with primary aldosteronism","volume":"98","author":"Mulatero","year":"2013","unstructured":"Mulatero PMonticone SBertello CViola ATizzani DIannaccone ACrudo VBurrello JMilan ARabbia F, Long-term cardio- and cerebrovascular events in patients with primary aldosteronism. Journal of Clinical Endocrinology and Metabolism2013984826\u20134833. (https:\/\/doi.org\/10.1210\/jc.2013-2805)"},{"key":"bib16","series-title":"Hypertension","first-page":"530","article-title":"Prevalence of cardiovascular disease and its risk factors in primary aldosteronism: a multicenter study in japan","volume":"71","author":"Ohno","year":"2018","unstructured":"Ohno YSone MInagaki NYamasaki TOgawa OTakeda YKurihara IItoh HUmakoshi HTsuiki M, Prevalence of cardiovascular disease and its risk factors in primary aldosteronism: a multicenter study in japan. Hypertension201871530\u2013537. (https:\/\/doi.org\/10.1161\/HYPERTENSIONAHA.117.10263)"},{"key":"bib17","series-title":"Journal of Electrocardiology","first-page":"760","article-title":"Frequent premature atrial complexes as a predictor of atrial fibrillation: systematic review and meta-analysis","volume":"51","author":"Prasitlumkum","year":"2018","unstructured":"Prasitlumkum NRattanawong PLimpruttidham NKanitsoraphan CSirinvaravong NSuppakitjanusant PChongsathidkiet P & Chung EH. Frequent premature atrial complexes as a predictor of atrial fibrillation: systematic review and meta-analysis. Journal of Electrocardiology201851760\u2013767. (https:\/\/doi.org\/10.1016\/j.jelectrocard.2018.05.012)"},{"key":"bib18","series-title":"Europace","first-page":"204","article-title":"Onset mechanism of paroxysmal atrial fibrillation detected by ambulatory holter monitoring","volume":"8","author":"Vincenti","year":"2006","unstructured":"Vincenti ABrambilla RFumagalli MGMerola R & Pedretti S. Onset mechanism of paroxysmal atrial fibrillation detected by ambulatory holter monitoring. Europace20068204\u2013210. (https:\/\/doi.org\/10.1093\/europace\/euj043)"},{"key":"bib19","series-title":"Medical Science Monitor","first-page":"CS174","article-title":"Life-threatening arrhythmia caused by primary aldosteronism","volume":"15","author":"Zelinka","year":"2009","unstructured":"Zelinka THolaj RPetr\u00e1k OStrauch BKasalick\u00fd MHanus TMelenovsk\u00fd VVancura VB\u00fcrgelov\u00e1 M & Widimsk\u00fd JJr. Life-threatening arrhythmia caused by primary aldosteronism. Medical Science Monitor200915CS174\u2013CS177."},{"key":"bib20","series-title":"Mayo Clinic Proceedings","first-page":"1778","article-title":"The state of the art: atrial fibrillation epidemiology, prevention, and treatment","volume":"91","author":"Morin","year":"2016","unstructured":"Morin DPBernard MLMadias CRogers PAThihalolipavan S & Estes NA3rd. The state of the art: atrial fibrillation epidemiology, prevention, and treatment. Mayo Clinic Proceedings2016911778\u20131810. (https:\/\/doi.org\/10.1016\/j.mayocp.2016.08.022)"},{"key":"bib21","series-title":"Hormone and Metabolic Research","first-page":"357","article-title":"Atrial fibrillation in primary aldosteronism","volume":"52","author":"Pan","year":"2020","unstructured":"Pan CTTsai CHChen ZWChang YYWu VCHung CSLin YH & TAIPAI Study Group. Atrial fibrillation in primary aldosteronism. Hormone and Metabolic Research202052357\u2013365. (https:\/\/doi.org\/10.1055\/a-1141-5989)"},{"key":"bib22","series-title":"Circulation. Arrhythmia and Electrophysiology","first-page":"e004667","article-title":"Electrophysiology of hypokalemia and hyperkalemia","volume":"10","author":"Weiss","year":"2017","unstructured":"Weiss JNQu Z & Shivkumar K. Electrophysiology of hypokalemia and hyperkalemia. Circulation. Arrhythmia and Electrophysiology201710e004667. (https:\/\/doi.org\/10.1161\/CIRCEP.116.004667)"},{"key":"bib23","series-title":"Journal of Hypertension","first-page":"1841","article-title":"Prevalence of primary aldosteronism and association with cardiovascular complications in patients with resistant and refractory hypertension","volume":"38","author":"Parasiliti-Caprino","year":"2020","unstructured":"Parasiliti-Caprino MLopez CPrencipe NLucatello BSettanni FGiraudo GRossato DMengozzi GGhigo EBenso A, Prevalence of primary aldosteronism and association with cardiovascular complications in patients with resistant and refractory hypertension. Journal of Hypertension2020381841\u20131848. (https:\/\/doi.org\/10.1097\/HJH.0000000000002441)"},{"key":"bib24","series-title":"Journal of Neuroendocrinology","first-page":"115","article-title":"Acute effects of aldosterone on the autonomic nervous system and the baroreflex function in healthy humans","volume":"18","author":"Heindl","year":"2006","unstructured":"Heindl SHolzschneider JHinz ASayk FFehm HL & Dodt C. Acute effects of aldosterone on the autonomic nervous system and the baroreflex function in healthy humans. Journal of Neuroendocrinology200618115\u2013121. (https:\/\/doi.org\/10.1111\/j.1365-2826.2005.01392.x)"},{"key":"bib25","series-title":"Endocrinology","first-page":"819","article-title":"Intracerebroventricular infusion of aldosterone induces hypertension in rats","volume":"118","author":"Gomez-Sanchez","year":"1986","unstructured":"Gomez-Sanchez EP. Intracerebroventricular infusion of aldosterone induces hypertension in rats. Endocrinology1986118819\u2013823. (https:\/\/doi.org\/10.1210\/endo-118-2-819)"},{"key":"bib26","series-title":"Journal of the American College of Cardiology","first-page":"291","article-title":"Cardiac autonomic dysfunction and incidence of atrial fibrillation: results from 20 years follow-up","volume":"69","author":"Agarwal","year":"2017","unstructured":"Agarwal SKNorby FLWhitsel EASoliman EZChen LYLoehr LRFuster VHeiss GCoresh J & Alonso A. Cardiac autonomic dysfunction and incidence of atrial fibrillation: results from 20 years follow-up. Journal of the American College of Cardiology201769291\u2013299. (https:\/\/doi.org\/10.1016\/j.jacc.2016.10.059)"},{"key":"bib27","series-title":"European Journal of Clinical Investigation","first-page":"e13174","article-title":"Heart rate variability in atrial fibrillation: the balance between sympathetic and parasympathetic nervous system","volume":"49","author":"Khan","year":"2019","unstructured":"Khan AALip GYH & Shantsila A. Heart rate variability in atrial fibrillation: the balance between sympathetic and parasympathetic nervous system. European Journal of Clinical Investigation201949e13174. (https:\/\/doi.org\/10.1111\/eci.13174)"},{"key":"bib28","series-title":"Journal of Cardiovascular Electrophysiology","first-page":"285","article-title":"Fluctuation in autonomic tone is a major determinant of sustained atrial arrhythmias in patients with focal ectopy originating from the pulmonary veins","volume":"12","author":"Zimmermann","year":"2001","unstructured":"Zimmermann M & Kalusche D. Fluctuation in autonomic tone is a major determinant of sustained atrial arrhythmias in patients with focal ectopy originating from the pulmonary veins. Journal of Cardiovascular Electrophysiology200112285\u2013291. (https:\/\/doi.org\/10.1046\/j.1540-8167.2001.00285.x)"},{"key":"bib29","series-title":"Biological Research for Nursing","first-page":"45","article-title":"Heart rate variability and risk of all-cause death and cardiovascular events in patients with cardiovascular disease: a meta-analysis of cohort studies","volume":"22","author":"Fang","year":"2020","unstructured":"Fang SCWu YL & Tsai PS. Heart rate variability and risk of all-cause death and cardiovascular events in patients with cardiovascular disease: a meta-analysis of cohort studies. Biological Research for Nursing20202245\u201356. (https:\/\/doi.org\/10.1177\/1099800419877442)"},{"key":"bib30","series-title":"Hormone and Metabolic Research","first-page":"831","article-title":"Aldosterone to renin ratio as a screening instrument for primary aldosteronism in a middle-aged population with atrial fibrillation","volume":"49","author":"Mourtzinis","year":"2017","unstructured":"Mourtzinis GEbrahimi AGustafsson HJohannsson G & Manhem K. Aldosterone to renin ratio as a screening instrument for primary aldosteronism in a middle-aged population with atrial fibrillation. Hormone and Metabolic Research201749831\u2013837. (https:\/\/doi.org\/10.1055\/s-0043-119220)"},{"key":"bib31","series-title":"Journal of Molecular and Cellular Cardiology","first-page":"865","article-title":"Induction of cardiac fibrosis by aldosterone","volume":"32","author":"Lijnen","year":"2000","unstructured":"Lijnen P & Petrov V. Induction of cardiac fibrosis by aldosterone. Journal of Molecular and Cellular Cardiology200032865\u2013879. (https:\/\/doi.org\/10.1006\/jmcc.2000.1129)"},{"key":"bib32","series-title":"European Heart Journal","first-page":"354","article-title":"Standards of measurement, physiological interpretation, and clinical use. Task force of the European Society of Cardiology and the North American society of pacing and electrophysiology","volume":"17","year":"1996","unstructured":"HeartRate Variability. Standards of measurement, physiological interpretation, and clinical use. Task force of the European Society of Cardiology and the North American society of pacing and electrophysiology. European Heart Journal199617354\u2013381. (https:\/\/doi.org\/10.1093\/oxfordjournals.eurheartj.a014868)"}],"container-title":["Endocrine Connections"],"original-title":[],"link":[{"URL":"https:\/\/ec.bioscientifica.com\/view\/journals\/ec\/12\/12\/EC-23-0359.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ec.bioscientifica.com\/downloadpdf\/journals\/ec\/12\/12\/EC-23-0359.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/ec.bioscientifica.com\/downloadpdf\/journals\/ec\/12\/12\/EC-23-0359.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:46:52Z","timestamp":1784555212000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/ec\/article\/1601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,20]]},"references-count":32,"journal-issue":{"issue":"12"},"URL":"https:\/\/doi.org\/10.1530\/ec-23-0359","relation":{},"ISSN":["2049-3614"],"issn-type":[{"value":"2049-3614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,20]]}}}