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耐性高血圧における一次性高アルドステロン症の有病率:遡及的観察研究
Stella Douma1, Konstantinos Petidis, Michael Doumas
1Second Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Greece.
Lancet (London, England)
|June 10, 2008
まとめ
プライマリ・ハイパーアルドステロン症は,耐性高血圧患者の11.3%に罹患しており,これは以前に示唆されたより低い罹患率です. この研究は,一般的な高血圧患者集団におけるこの状態の流行の考えに異議を唱える.
科学分野:
- エンドクリノロジー エンドクリノロジー
- 高血圧の研究 高血圧の研究
- クリニカル・メディシン 臨床医学
背景:
- 高血圧における一次性高アルドステロン症 (コーン症候群) の罹患率は議論されているが,推定値は10%以上である.
- 限られた研究に基づいて,耐性高血圧は,一次性高アルドステロン症の最も高い罹患率を持つと考えられています.
- この研究は,大規模な耐性高血圧コホートにおける実際の罹患率を決定することを目的とした.
研究 の 目的:
- 耐性高血圧の患者における一次性高アルドステロン症の有病率を正確に評価する.
- 発見を以前の推定値と比較し,疫病の概念を評価する.
主な方法:
- 耐性高血圧の患者1616人が20年以上にわたって評価されました.
- 最初のスクリーニングは,血清アルドステロンと血レニンの活性比率を対象とした.
- 陽性症例は塩分抑制検査を受け,スピロノラクトン治療への反応によって確認されました.
主要な成果:
- 患者の11.3% (182/1616) が初発性高アルドステロン症と診断されました.
- この流行率は,以前の報告よりも低い.
- 低血量症は,診断された患者の45.6%にのみ存在していました.
結論:
- 耐性高血圧における一次性高アルドステロン症の罹患率は有意であるが,しばしば引用されるよりも低い.
- 一般的な高血圧患者集団における高い罹患率は,過大評価されている可能性が高い.
- 主要なハイパーアルドステロン症の流行の概念は,これらの発見によって支持されていません.
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