Screening for primary aldosteronism in a cohort of Brazilian patients with resistant hypertension.
The objective was to estimate the prevalence of plasma aldosterone concentration:plasma renin activity ratio >30 ng/dL:ng/mL/h in patients with resistant hypertension and to describe the computed tomography findings of adrenal glands in those with elevated ratios. In a cross-sectional design, 492 patients were enrolled. All patients with plasma aldosterone concentration:plasma renin activity ratio >or=30 ng/dL:ng/mL/h (n=77) underwent abdominal computed tomography. Patients with an adrenal image of possible aldosterone-producing adenoma underwent a saline-loading test. The prevalence of elevated plasma aldosterone concentration:plasma renin activity ratio was 15.7% (95% confidence interval, 12.6-19.2). Twelve patients showed adrenal abnormalities on computed tomography. The level of renin was low in 50% of the sample. Results indicate a low prevalence of aldosterone-producing adenoma. Our evidence points out the importance of confirming the hypothesis that essential hypertension, low-renin hypertension, and idiopathic hyperaldosteronism could be the same disease, but at different neurohormonal stages, and aldosterone-producing adenoma may be yet another disease.
Nogueira
Armando R
AR
Hypertension Program, University Hospital Clementino Fraga Filho, Brazil. armando@hucff.ufrj.br
Bloch
Katia V
KV
D000236:Adenoma / Q000097:blood / Q000000981:diagnostic imaging; D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000000981:diagnostic imaging; D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis*; D006965:Hyperplasia; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012083:Renin / Q000097:blood*; D014057:Tomography, X-Ray Computed
D000450:Aldosterone; D012083:Renin
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