[Primary aldosteronism: analysis of a series of 54 patients].
OBJECTIVE
The prevalence of primary aldosteronism (PA) has experienced an important increase, and many authors consider this condition as the main cause of secondary hypertension (HT).


METHODS
Retrospective study of a series of 54 patients having PA who were studied in our Unit between 1999 and 2003.


RESULTS
The prevalence of PA was 5.1%. Out of 54 PA cases, 13 corresponded to aldosterone-producing adenomas (APA), 30 to bilateral adrenal hyperplasia (BAH), one was one case of nodular bilateral hyperplasia and another case was a nodular unilateral hyperplasia. In 9 cases, an etiologic diagnosis could not be done. APA were more frequent in women and BAH in men; with regard to sex, no significant differences were found. The blood pressure (BP) was significantly higher in patients with APA compared with BAH patients. In patients with APA, kalemia was significantly lower than in BAH patients. Adrenal CT scan identified 90% of APA, while scintigraphy detected 100% of BAH. Spironolactone therapy significantly decreased the BP in APA and BAH patients, although this fall was higher in patients with APA.


CONCLUSIONS
The prevalence of PA was 5.1%. Although the tests used for the screening and diagnosis of PA are controversial, a PA ought to be investigated in all patients with refractory HT, independently of the existence of hypokalemia. Spironolactone is an effective therapy for BAH and it is an adequate option for APA treatment when an adrenalectomy is not viable.
Sabio
José Mario
JM
Unidad de Hipertensión Arterial y Lípidos, Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, España. masabio@terra.es
Mediavilla-García
Juan Diego
JD
Jaén
Fernando
F
Fernández-Torres
Celia
C
Aliaga
Luis
L
Jiménez-Alonso
Juan
J
D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D015995:Prevalence; D012189:Retrospective Studies; D013148:Spironolactone / Q000627:therapeutic use*
D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone