Investigation of the prevalence of primary aldosteronism among newly diagnosed patients with hypertension / 中国基层医药

ABSTRACT

Objective To observe the morbidity and clinical characteristics of primary aldosteronism (PA) in newly diagnosed patients with hypertension.Methods 255 patients with newly diagnosed high blood pressure were determined plasma renin activity (PRA),angiotensinⅡ(ATⅡ),aldosterone (PAC),cortisol (COR),adrenocortico-tropic hormone (ACTH)and 24h urinary vanilmandelic acid (VMA).They were examined renal artery color doppler and adrenal 64 row CT scan +enhancement scanning.Results 179 patients (70.20%)were diagnosed essential hypertension (EH).In EH patients,24 cases (13.41%)with hypokalemia.42 patients (16.47%)were diagnosed PA.In PA patients,18 cases (42 .86 %)with hypokalemia,25 cases(5 9 .5 2 % )with unilateral adrenal adenoma. Compared with EH patients,there were higher level of high density lipoprotein (HDL -C)(Z =-2.068,P =0.036),lower level of total cholesterol (TC),low density lipoprotein (LDL -C),fasting plasma glucose (FPG), serum kalium (Z =3.594,P =0.000;Z =2.807,P =0.005;Z =3.499,P =0.000;Z =8.435,P =0.000)in PA patients.The levels of plasma PRA and ATⅡin PA patients were lower than in EH patients(Z =3.673,P =0.000;Z =2.215,P =0.026).The levels of plasma PAC and ARR were higher than in EH patients (Z =8.562,P =0.000;Z =19.871,P =0.000).The minimum value of plasma PAC was 292.1pg/L,the ARR was 376.7 in 42 PA patients. The maximum value of plasma PAC was 311.3pg/L,and the ARR was 291.2.Conclusion There is high detection rate of PA in newly diagnosed hypertension.The unilateral adrenal adenoma is a main cause of PA.Hypokalemia is not common in PA patients.PA has little influence on glucolipid metabolism.ARR has high differential diagnosis accuracy for PA and EH.