Association of Aldosterone Excess with Hematological Parameters and Inflammatory Indices in Hypertensive Patients

Objective: Despite being one of the most common causes of secondary hypertension, primary aldosteronism (PA) is frequently underdiagnosed. This study aimed to
evaluate the associations between biochemical markers used in PA screening (plasma aldosterone concentration [PAC], plasma renin activity [PRA], and aldosteroneto-
renin ratio) and routinely measured hematological parameters (leukocyte, neutrophil, lymphocyte, and platelet counts), as well as inflammatory indices derived
from these parameters (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and the Systemic Immune-Inflammation Index [SII]).
Materials and Methods: This retrospective study analyzed data from 169 hypertensive patients who underwent PA screening between January 2021 and December
2023. Patients were grouped according to PAC cut-off values of ≥15 ng/dL and ≥30 ng/dL. Associations between PAC, PRA, and hematological parameters were
assessed using correlation, multivariable linear regression, and receiver operating characteristic (ROC) curve analyses.
Results: Platelet count was significantly higher in patients with PAC ≥15 ng/dL and PAC ≥30 ng/dL (p = 0.041 and p < 0.001, respectively). In multivariable regression
analyses, platelet count (p = 0.001), PLR (p = 0.012), and SII (p = 0.044) remained independently associated with PAC. In ROC analysis, platelet count demonstrated
statistically significant discriminative performance for PAC ≥30 ng/dL (AUC = 0.727, p = 0.001).
Conclusion: Leukocyte-based hematological parameters and inflammatory indices were not significantly associated with PA screening markers. However, the modest
association between platelet count and PAC suggests a potential link with aldosterone activity. Further studies are needed to clarify the clinical relevance of this
finding.