Data-driven cluster analysis and external validation identify phenotypic subgroups in renin-independent aldosteronism with differential cardiovascular risk and therapeutic implications
We identified 3 subgroups with differing degrees of target organ damage and cardiovascular risk. Our findings establish metabolic dysfunction, rather than aldosterone excess, as a potential dominant cardiovascular risk driver in RIA patients, defining a new risk paradigm. Patients with renin-independent aldosteronism with metabolic dysfunction or high aldosterone levels may benefit from mineralocorticoid receptor antagonists with different priorities for metabolic and cardiovascular protection. This new refined classification may help tailor optimal treatment strategies for patients with heterogenous renin-independent aldosteronism.
Authors
- Jun Tao (ORCID: https://orcid.org/0000-0003-2899-0248)
- Meiling Bao (ORCID: https://orcid.org/0009-0007-9223-729X)
- Jun Yang (ORCID: https://orcid.org/0000-0002-7460-2800)
- Yutong Yan
- Yuqing Liu (ORCID: https://orcid.org/0000-0001-5877-5544)
- Maoting Gao (ORCID: https://orcid.org/0000-0002-9986-9413)
- Yuhong Yang (ORCID: https://orcid.org/0000-0002-3043-8463)
- Cong Wang (ORCID: https://orcid.org/0000-0003-2626-9596)
- Zhiheng Zhang (ORCID: https://orcid.org/0000-0003-4299-5379)
- Mei Zhou (ORCID: https://orcid.org/0000-0002-1297-2777)
- Min Sun (ORCID: https://orcid.org/0000-0001-5664-0734)
- Haifeng Zhou (ORCID: https://orcid.org/0000-0002-7564-5087)
Institutions
- Nanjing Drum Tower Hospital (CN)
- Nanjing Medical University (CN)
Publication Details
- Journal
- Frontiers in Endocrinology
- Published
- 2025-12-15
- DOI
- https://doi.org/10.3389/fendo.2025.1686480
- Primary Topic
- Hormonal Regulation and Hypertension
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Natural Science Foundation of China
- China Postdoctoral Science Foundation
- Government of Jiangsu Province
- Natural Science Foundation of Jiangsu Province