Association Between Papillary Thyroid Cancer and Primary Aldosteronism in Individuals With Hypertension

Abstract

Context: Aldosterone excess chronically induces oxidative stress and cell proliferation. Previously, a single study investigated primary aldosteronism (PA) in patients with papillary thyroid cancer (PTC), albeit without a matched control group.

Objective: We conducted a propensity score-matched, case-control study to investigate the association between PA and PTC in individuals with arterial hypertension (HT).

Methods: PA was investigated in 137 patients with PTC and HT. The control group included 137 (1:1) age-, sex-, and body mass index-matched individuals with HT. We conducted a secondary analysis in which controls were also matched according to HT stage.

Results: The prevalence of PA was 29.20% (95% CI, 21.91%-37.68%) in the PTC group and 20.44% (95% CI, 14.22%-28.35%) in the controls not matched by HT stage (P = .093). Although the PA prevalence was similar in both groups, the frequency of severe HT (stage III or resistant) was significantly lower in the PTC group (23%) compared to the HT controls (73%; P < .001). After matching the controls by HT stage, the prevalence of PA in the PTC group was significantly higher compared to the hypertensive controls (9.56%; 95% CI, 5.39%-16.1%; P < .0001). In the multivariable analysis, PTC was independently associated with PA both in unmatched HT individuals (odds ratio [OR] 4.74; 95% CI, 2.26-10.55; P < .001) and in those matched by HT stage (OR 5.88; 95% CI, 2.79-13.37; P < .001).

Conclusion: PTC was an independent variable associated with a diagnosis of PA in HT individuals. Therefore, we propose the association between PTC and HT as a new recommendation for PA screening regardless of HT severity.

Keywords: hypertension; papillary thyroid cancer; primary aldosteronism; screening.