High prevalence of liddle syndrome phenotype among hypertensive US Veterans in Northwest Louisiana.
Liddle syndrome (LS) is an autosomal dominant disorder due to a gain-of-function mutation in the epithelial Na(+) channel and is perceived to be a rare condition. A cross-sectional study of 149 hypertensive patients with hypokalemia (<4 mmol/dL) or elevated serum bicarbonate (>25 mmol/dL) was conducted at a Veterans' Administration Medical Center Hypertension Clinic in Shreveport, LA. Data on demographics, blood pressure, and select blood tests were collected and expressed as percentages for categoric variables and as mean ± standard deviation (SD) for continuous variables. Patients were diagnosed with likely LS when the plasma renin activity (PRA) was <0.35 μU/mL/h and the aldosterone was <15 ng/dL and likely primary hyperaldosteronism (PHA) with PRA <0.35 μU/mL/h and aldosterone level >15 ng/dL. The cohort included predominantly elderly (67.1±13.4 years), male (96%), and Caucasian (57%) patients. The average blood pressure was 143.8/79.8 mm Hg±27.11/15.20 with 3.03±1.63 antihypertensive drugs. Based on the above criteria, 9 patients (6%) satisfied the criteria for likely LS and 10 patients (6.7%) were diagnosed with likely PHA. In this hypothesis-generating study, the authors detected an unusually high prevalence of biochemical abnormalities compatible with likely LS syndrome from Northwestern Louisiana, approaching that of likely PHA.
Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
Mihály
M
Tapolyai
Aşkin
A
Uysal
Neville R
NR
Dossabhoy
Lajos
L
Zsom
Tibor
T
Szarvas
Zsolt
Z
Lengvárszky
Tibor
T
Fülöp
D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000378:metabolism; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001639:Bicarbonates / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D003430:Cross-Sectional Studies; D053503:Epithelial Sodium Channels / Q000235:genetics; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism; D007008:Hypokalemia / Q000378:metabolism; D056929:Liddle Syndrome / Q000150:complications / Q000453:epidemiology / Q000235:genetics; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012083:Renin / Q000378:metabolism; D058014:Veterans Health
D000959:Antihypertensive Agents; D001639:Bicarbonates; D053503:Epithelial Sodium Channels; D000450:Aldosterone; D012083:Renin