{"id":"a327e943dffa","type":"article","url":"https://hartvaat.nl/2026/03/25/sekseverschillen-in-hartremodellering-bij-primair-aldosteronisme-vrouwen-hebben-/","title":"Sekseverschillen in hartremodellering bij primair aldosteronisme: vrouwen hebben een ongunstiger fenotype","title_en":"Sex Differences in Cardiac Remodeling and Dysfunction in Primary Aldosteronism","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","internist"],"tags":["vrouwen"],"journal":"Hypertension","doi":"https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26213","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26213","authors":[],"significance":6,"published":"2026-03-25","source_date":"2026-03-25","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/hypertensie/hypertensie-en-diabetes/"],"congress":"","summary_en":"Sex differences influence cardiovascular risk assessment, but their role in aldosterone-mediated cardiac remodelling in primary aldosteronism (PA) was incompletely understood. In this retrospective study (547 PA patients: 249 men, 298 women), clinical and echocardiographic data were collected at baseline and after one year of aldosterone-targeted therapy. At baseline, men had a higher left ventricular mass index (LVMI), but women more often had LV hypertrophy and worse diastolic function (higher E/e' and left atrial volume index). Plasma aldosterone concentration was associated with LVMI in both sexes. After one year, LVMI reduction was comparable between sexes, but diastolic function improved less in women. Despite lower LVMI, women with PA thus have a more adverse cardiac phenotype that recovers less well after treatment.","created":"2026-07-03T10:32:21Z","updated":"2026-07-03T13:31:18Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Sekseverschillen beïnvloeden de cardiovasculaire risico-inschatting, maar hun rol bij aldosteron-gemedieerde hartremodellering bij primair aldosteronisme (PA) was onvolledig bekend. In deze retrospectieve studie (547 PA-patiënten: 249 mannen, 298 vrouwen) werden klinische en echografische gegevens verzameld bij aanvang en na één jaar aldosteron-gerichte behandeling. Bij aanvang hadden mannen een hogere linkerventrikelmassa-index (LVMI), maar vrouwen vaker linkerventrikelhypertrofie en een slechtere diastolische functie (hogere E/e' en linkeratriumvolume-index). De plasma-aldosteronconcentratie hing bij beide seksen samen met de LVMI. Na één jaar was de afname van de LVMI vergelijkbaar tussen de seksen, maar verbeterde de diastolische functie bij vrouwen minder. Ondanks een lagere LVMI hebben vrouwen met PA dus een ongunstiger cardiaal fenotype, dat na behandeling minder goed herstelt.","abstract_original":"Hypertension, Volume 83, Issue 5, Page e26213, May 1, 2026. BACKGROUND:Sex differences influence cardiovascular risk assessment and management; however, their role in aldosterone-mediated cardiac remodeling in primary aldosteronism remains incompletely understood.METHODS:We conducted a retrospective study of 547 patients with primary aldosteronism, including 249 men and 298 women. Clinical and echocardiographic data were collected at baseline and 1 year following aldosterone-targeted therapies.RESULTS:The mean age was 53.8 years in men and 54.6 years in women. At baseline, men had a higher left ventricular mass index (LVMI), whereas women had a higher prevalence of left ventricular (LV) hypertrophy and worse diastolic function, as indicated by a higher ratio of early diastolic transmitral to mitral annular velocity (E/e′) and left atrial volume index. In multivariable analyses, plasma aldosterone concentration (PAC) was associated with baseline LVMI in both sexes. Associations between "}