Association of calcium, aldosterone and renine biochemistry with subclinical and clinical atherosclerosis: cross-sectional analysis of the Longitudinal Study for Adult Health (ELSA-Brasil)

• Grant number: 24/14041-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2024
• End date: September 30, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Madson Queiroz Almeida
• Grantee: Gustavo Henrique Mori
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated research grant: 19/15873-6 - Investigation of new genetic, clinical and pathological aspects of endocrine arterial hypertension, AP.TEM

Abstract

Primary aldosteronism (PA) is the most common cause of endocrine hypertension (HT), with a prevalence of 20% among resistant hypertensives. PA is associated with cardiovascular (CV) effects that are independent of blood pressure levels, such as heart failure and coronary artery disease. There is growing evidence of a clinically relevant and complex interaction between the renin-angiotensin-aldosterone system (RAAS) and the calcium regulatory axis. The bidirectional and stimulatory relationship between RAAS and parathyroid hormone (PTH) has implications for the mechanism of CV diseases. Coronary artery calcification (CAC) measured by computed tomography (CT) is associated with an increased risk of CV diseases, even in the asymptomatic population. Some risk factors are associated with the incidence and progression of CAC, such as HT and diabetes mellitus. Although imbalances in calcium-phosphorus metabolism and PTH levels have been associated with an increased risk of CV disease, the associations with the incidence and progression of CAC have not yet been established. Thus, the objectives of the study are: 1) to evaluate the association of calcium metabolism with the incidence and progression of subclinical and clinical atherosclerosis in the fourth wave of ELSA-Brasil; 2) to determine serum aldosterone levels and direct plasma renin concentration in the fourth wave of ELSA-Brasil and investigate the association with CAC, hypertension, microalbuminuria, and metabolic syndrome; 3) to investigate the correlation between aldosterone and renin levels with calcium biochemistry in the fourth wave of ELSA-Brasil. The methodologies used will include biochemical analyses, measurement of CAC by CT, intima-media thickness (IMT), and carotid plaques by ultrasonography.