1. Prevalence of Primary Aldosteronism Across the Stages of Hypertension Based on a New Combined Overnight Test
- Author
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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, and George Piaditis
- Subjects
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 - Abstract
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
- Published
- 2021