Association of Plasma Aldosterone Concentration with Peripheral Artery Disease in Hypertensive Patients: Insights from a Large Cross-Sectional Analysis

Yingying Zhang ¹ Xintian Cai ¹ Shuaiwei Song ¹ Hu Junli ² Pan Zhou ¹ Kangxin Cai ¹ Rui Ma ¹ Huimin Ma ¹ Di Shen ¹ Wenbo Yang ² Delian Zhang ² Luo Qin ² Jing Hong ² Nanfang Li ^1,2*

• ¹ Xinjiang Medical University, Ürümqi, China
• ² People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang Uyghur Region, China

Objectives: To investigate the relationship between plasma aldosterone concentration (PAC) and the prevalence of peripheral artery disease (PAD) in hypertensive patients and to determine any potential threshold effects.This cross-sectional study analyzed data from 13,157 hypertensive individuals from the People's Hospital of Xinjiang Uygur Autonomous Region, China. PAD was diagnosed based on an ankle-brachial index (ABI) of ≤0.90. A multivariate logistic regression model was utilized to evaluate the association between PAC and PAD, and a generalized additive model (GAM) was employed to explore non-linear relationships.The fully adjusted logistic regression model revealed a significant positive association between PAC and PAD, with an odds ratio (OR) [95% confidence interval (CI)] of 1.06 (1.04, 1.08) per unit increase in PAC. The GAM identified a critical threshold at 17.00 ng/dL for PAC, above which the prevalence of PAD increased by 9% for each unit increase in PAC, with an OR (95% CI) of 1.09 (1.06, 1.11). Sensitivity and subgroup analyses confirmed the robustness of these findings.This study establishes a non-linear relationship between PAC and the prevalence of PAD in hypertensive patients, with a critical threshold at 17.00 ng/dL. These findings underscore the importance of aldosterone homeostasis in vascular health and the need for further large-scale, prospective studies to validate these results and explore their clinical implications.