Prevalence of primary hyperaldosteronism in a systemic arterial hypertension league.
BACKGROUND
Until recently, primary hyperaldosteronism was considered a rare cause of secondary hypertension. However, in recent years, many studies have suggested that this disease can affect up to 20% of hypertensive individuals.


OBJECTIVE
To determine the prevalence of primary hyperaldosteronism in hypertensive patients treated at the hypertension league of a university hospital.


METHODS
Serum aldosterone and plasma renin activity levels were measured in 105 patients while they were undergoing standard antihypertensive treatment, with the exception of those using betablockers and spironolactone, in fasting condition and after rest in the supine position for 20 minutes. Those with an aldosterone/plasma renin activity ratio > 25 were submitted to the saline suppression test and, after the confirmation of the autonomy of aldosterone secretion, a computed tomography of the adrenals was performed. The results are presented as percentages and means and standard deviations.


RESULTS
Of the 105 patients, 6.54% presented refractory hypertension. Nine presented an aldosterone/plasma renin activity ratio > 25 (8.5% of the total). Of these, 08 were submitted to the saline suppression test and 01 (with refractory hypertension) had the diagnosis of primary hyperaldosteronism confirmed (0.96% of the total). A computed tomography of the adrenals was performed, which showed normal results.


CONCLUSIONS
The prevalence of primary hyperaldosteronism in the studied sample was 0.96% of the total. However, when only the patients with refractory hypertension were evaluated, the prevalence was 14.3%.
Ribeiro
Maria Jacqueline Silva
MJ
Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, São Luís, MA, Brazil.
Figueiredo Neto
José Albuquerque de
JA
Memória
Edson Viriato
EV
Lopes
Maíra de Castro
Mde C
Faria
Manuel dos Santos
Mdos S
Salgado Filho
Natalino
N
Oliveira
Thiara Castro de
TC
D000311:Adrenal Glands / Q000473:pathology; D000450:Aldosterone / Q000097:blood* / Q000378:metabolism; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000453:epidemiology*; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012016:Reference Values; D012083:Renin / Q000097:blood*; D012146:Rest
D000959:Antihypertensive Agents; D000450:Aldosterone; D012083:Renin