TOPLINE:

Salivary free aldosterone awakening response (AldAR) differed in men with coronary heart disease and essential hypertension compared with healthy control individuals with normotension. Higher AldAR seemed to predict the future risk for coronary heart disease due to its association with risk factors such as inflammatory markers and blood lipid profiles.

METHODOLOGY:

• Researchers cross-sectionally compared the salivary free AldAR among men with coronary heart disease, essential hypertension, and normotension and prospectively evaluated whether the AldAR could predict the risk for coronary heart disease.
• This cross-sectional analysis included 60 patients with coronary heart disease (mean age, 65.93 years), 40 patients with essential hypertension (mean age, 51.80 years), and 44 control individuals with normotension (mean age, 51.57 years).
• The salivary free AldAR was repeatedly evaluated on 2 consecutive days using saliva samples collected immediately after awakening and at 15, 30, 45, and 60 minutes thereafter.
• The prospective analysis followed 97 participants for a mean duration of 2.95 years and assessed changes in biological risk factors such as inflammatory markers and blood lipid profiles.

TAKEAWAY:

• Men with coronary heart disease showed the expected post-awakening AldAR (P = .024) but had lower overall aldosterone levels than those with normotension.
• Compared with men with normotension, those with essential hypertension had higher overall aldosterone levels (P = .010) but a flattened AldAR (P = .89).
• Higher AldAR area under the curve (AUC_AldAR) independently predicted greater increases in inflammatory parameters (P = .024).
• Higher AUC_AldAR was associated with greater increases in low-density lipoprotein cholesterol (P = .037) and total cholesterol (P = .032) levels in a univariate analysis; however, these associations weakened to trend levels after further adjustment for covariates.

IN PRACTICE:

"Our results suggest that dysregulation in terms of an increased AldAR may represent an early indicator for increased cardiovascular risk," the authors wrote.

SOURCE:

This study was led by Angelina Gideon, Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany. It was published online on January 05, 2026, in Frontiers in Endocrinology.

LIMITATIONS:

This study had a relatively high dropout rate attributed to logistical challenges, particularly related to changes in study sites between institutions. The sample was limited to only middle-aged men of relatively high socioeconomic status. Although renin-angiotensin-aldosterone system-modulating drugs may have influenced the AldAR, the limited sample size and the heterogeneity of medications prevented controlling for specific medication categories.

DISCLOSURES:

This study was supported by research grants from the Swiss National Science Foundation, German Research Foundation, German Scholars Organization, and University Hospital Bern. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.