Related Experiment Videos
Primary aldosteronism and hypertensive disease.
Lorena Mosso1, Cristian Carvajal, Alexis González
1Department of Endocrinology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Lira 85, 5 piso, Santiago, Chile. cfardella@med.puc.cl
Hypertension (Dallas, Tex. : 1979)
|June 11, 2003
Summary
Primary aldosteronism (PA) is common in essential hypertension, especially in later stages. Screening with the serum aldosterone (SA) to plasma renin activity (PRA) ratio identifies PA, often without hypokalemia or clear CT findings.
Area of Science:
- Endocrinology
- Hypertension Research
- Clinical Diagnostics
Background:
- Primary aldosteronism (PA) prevalence is underestimated using hypokalemia as a screening tool.
- Hypertension severity may influence PA detection rates.
- The serum aldosterone (SA) to plasma renin activity (PRA) ratio offers a more sensitive screening method.
Purpose of the Study:
- To evaluate the prevalence of PA in essential hypertensive patients.
- To assess the influence of hypertension stage on PA prevalence.
- To determine the utility of the SA-PRA ratio in screening for PA.
Main Methods:
- Studied 609 essential hypertensive patients classified by Joint National Committee VI (JNC VI) hypertension stage.
- Measured serum aldosterone (SA) and plasma renin activity (PRA).
- Calculated the SA-PRA ratio and confirmed diagnoses with the fludrocortisone test.
Main Results:
- Identified PA in 6.1% of patients (37 of 609).
- PA prevalence increased with hypertension stage: 1.99% (stage 1), 8.02% (stage 2), 13.2% (stage 3).
- Most PA patients had normal potassium levels and non-specific CT findings, suggesting attenuated forms.
Conclusions:
- The SA-PRA ratio is effective for screening PA in essential hypertension.
- PA is highly prevalent in moderate to severe hypertension (JNC VI stages 2 and 3).
- Attenuated forms of PA are common and may be missed by traditional screening methods.