Grant: Project Grant

Background: Hypertension (high blood pressure) management generally involves a 'one size fits all' approach. Employing a more personalized approach targeting the cause of an individual patient's hypertension provides the opportunity to improve long-term health. Primary aldosteronism (PA) is a common hormonal cause of hypertension that leads to disproportionately high rates of cardiovascular disease. Importantly, the adverse health consequences of PA are preventable with early targeted treatments which are distinct from other forms of hypertension. Recently, a growing body of evidence has demonstrated that milder forms of PA ('Subclinical PA') are exceedingly common in the general population yet go undetected in modern-day clinical practice. Whether Subclinical PA increases the risk for long-term adverse cardiovascular outcomes remains unknown. Purpose: To study the long-term effects of Subclinical PA on cardiovascular disease. Procedure: We will investigate Subclinical PA using CARTaGENE - a study which enrolled over 20,000 Québec residents in 2009-2010. These participants had blood samples stored at the date of enrollment, and follow-up data regarding their health has been collected since that time. We will use the stored blood samples to perform hormonal profiling and identify participants with Subclinical PA at the time of enrollment to determine their long-term cardiovascular outcomes. Outcome: We anticipate that participants with Subclinical PA will develop higher rates of cardiovascular disease compared to participants without Subclinical PA. Relevance to Patients: If indeed patients with Subclinical PA experience worse cardiovascular outcomes, the logical next step will be to study whether using medications that specifically target Subclinical PA (and are not used routinely as first-line hypertension therapy) will improve cardiovascular outcomes. This study will provide a much-needed step toward a more individualized approach to hypertension management.