Saline Infusion Test highly associated with the incidence of cardio- and cerebrovascular events in primary aldosteronism.
Primary aldosteronism (PA) is caused by excess secretion of aldosterone and is an independent risk factor for cardio-cerebro-vascular (CCV) events. The goal of treatment of PA should include prevention of CCV events. A definitive diagnosis of PA is established by confirmatory tests [saline infusion test (SIT), furosemide upright test (FUT) and captopril challenge test (CCT)]. However, there is no information on whether the hormone levels measured by these confirmatory tests are associated with CCV events. The aim of this retrospective study was to elucidate the relationship between the results of the above confirmatory tests and prevalence of CCV disease in patients with PA. The study subjects were 292 PA patients who were assessed for past history of CCV events at the time of diagnosis of PA. CCV events were significantly higher in patients with positive than negative SIT (12.8% vs. 3.3%, p=0.04). There were no differences in the incidences of CCV events between patients with positive and negative CCT and FUT (CCT: 11.0% vs. 3.9%, p=0.13, FUT: 6.1% vs. 5.7%, p=0.93). Our results demonstrated a higher incidence of CCV disease in PA SIT-positive patients compared to those with negative test. SIT is a potentially useful test not only for the diagnosis of PA but also assessment of the risk of CCV events.
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
Reiko
R
Hayashi
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
Daisuke
D
Tamada
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
Masahiko
M
Murata
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
Kosuke
K
Mukai
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
Tetsuhiro
T
Kitamura
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
Michio
M
Otsuki
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
Iichiro
I
Shimomura
D000368:Aged; D002216:Captopril; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology; D003955:Diagnostic Tests, Routine; D005260:Female; D005665:Furosemide; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000175:diagnosis*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment
D005665:Furosemide; D002216:Captopril
Captopril challenge test; Cardio- and cerebrovascular (CCV) events; Furosemide upright test; Primary aldosteronism; Saline infusion test