Related Experiment Video

Updated: Jun 25, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
06:08

A Novel Method: Super-selective Adrenal Venous Sampling

Published on: September 15, 2017

Prevalence of primary hyperaldosteronism in a systemic arterial hypertension league

Maria Jacqueline Silva Ribeiro1, José Albuquerque de Figueiredo Neto, Edson Viriato Memória

  • 1Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, São Luís, MA, Brazil.

Arquivos Brasileiros De Cardiologia
|February 17, 2009
PubMed

Insights

Primary hyperaldosteronism affects 0.96% of hypertensive patients. However, in those with refractory hypertension, the prevalence rises to 14.3%, highlighting a significant subgroup for further investigation.

Area of Science:

  • Endocrinology
  • Hypertension Research
  • Clinical Diagnostics

Background:

  • Primary hyperaldosteronism (PHA) was historically rare but now affects up to 20% of hypertensive individuals.
  • Early diagnosis and treatment of PHA are crucial for managing secondary hypertension.

Purpose of the Study:

  • To investigate the prevalence of primary hyperaldosteronism in hypertensive patients at a university hospital's hypertension clinic.
  • To assess the diagnostic yield of specific biochemical and imaging tests for PHA.

Main Methods:

  • Measured serum aldosterone and plasma renin activity in 105 hypertensive patients on standard treatment.
  • Utilized the aldosterone/plasma renin activity ratio (>25) as a screening tool, followed by saline suppression testing.
  • Performed adrenal computed tomography (CT) for patients with confirmed autonomous aldosterone secretion.

Main Results:

  • Overall prevalence of PHA was 0.96% (1 of 105 patients).
  • In patients with refractory hypertension (6.54% of the cohort), PHA prevalence was 14.3% (1 of 7 patients with high ARR).
  • Adrenal CT scans were normal in the confirmed PHA case.

Conclusions:

  • The study identified a low overall prevalence of PHA in the general hypertensive population studied.
  • Refractory hypertension significantly increases the likelihood of PHA, suggesting targeted screening in this subgroup.
  • Further research is warranted to refine diagnostic strategies for PHA, especially in resistant cases.
Abstract

Related Concept Videos

Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Hormonal Regulation01:33

Hormonal Regulation

The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

Antihypertensive Drugs: Angiotensin II Receptor Blockers

In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...