Prevalence of Primary Aldosteronism Across the Stages of Hypertension Based on a New Combined Overnight Test

Autor: Nick Voulgaris, Labrini Papanastasiou, Chara Kapsali, George P. Chrousos, Athina Markou, Sophia Vlachou, Ernestini Tyfoxylou, Eva Kassi, Evagelia Kyriazi, Alexandros Gryparis, Gregory Kaltsas, Chris Gravvanis, George Piaditis
Rok vydání: 2021
Předmět:
Adult
Male
medicine.medical_specialty
Endocrinology
Diabetes and Metabolism
Urinary system
Clinical Biochemistry
030209 endocrinology & metabolism
030204 cardiovascular system & hematology
Essential hypertension
Biochemistry
Gastroenterology
Young Adult
03 medical and health sciences
chemistry.chemical_compound
Basal (phylogenetics)
0302 clinical medicine
Endocrinology
Primary aldosteronism
Internal medicine
Hyperaldosteronism
Prevalence
medicine
Humans
Mass Screening
Prospective Studies
Prospective cohort study
Aldosterone
Aged
Greece
Aldosterone-to-renin ratio
Diagnostic Tests
Routine
business.industry
Incidence (epidemiology)
Biochemistry (medical)
General Medicine
Middle Aged
Prognosis
medicine.disease
chemistry
Case-Control Studies
Hypertension
Female
business
Biomarkers
Follow-Up Studies
Zdroj: Hormone and Metabolic Research. 53:461-469
ISSN: 1439-4286
0018-5043
Popis: Primary aldosteronism (PA) is the most common endocrine cause of arterial hypertension. Despite the increasing incidence of hypertension worldwide, the true prevalence of PA in hypertension was only recently recognized. The objective of the work was to estimate the prevalence of PA in patients at different stages of hypertension based on a newly developed screening-diagnostic overnight test. This is a prospective study with hypertensive patients (n=265) at stage I (n=100), II (n=88), and III (n=77) of hypertension. A group of 103 patients with essential hypertension without PA was used as controls. PA diagnosis was based on a combined screening-diagnostic overnight test, the Dexamethasone-Captopril-Valsartan Test (DCVT) that evaluates aldosterone secretion after pharmaceutical blockade of angiotensin-II and adrenocorticotropic hormone. DCVT was performed in all participants independently of the basal aldosterone to renin ratio (ARR). The calculated upper normal limits for post-DCVT aldosterone levels [3 ng/dl (85 pmol/l)] and post-DCVT ARR [0.32 ng/dl/μU/ml (9 pmol/IU)] from controls, were applied together to establish PA diagnosis. Using these criteria PA was confirmed in 80 of 265 (30%) hypertensives. The prevalence of PA was: 21% (21/100) in stage I, 33% (29/88) in stage II, and 39% (30/77) in stage III. Serum K+ levels were negatively correlated and urinary K+ was positively correlated in PA patients with post-DCVT ARR (r=–0.349, p
Databáze: OpenAIRE
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