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Primary aldosteronism among newly diagnosed and untreated hypertensive patients in a Swedish primary care area.

Westerdahl, Christina LU ; Bergenfelz, Anders LU ; Isaksson, Anders LU ; Nerbrand, Christina LU and Valdemarsson, Stig LU (2011) In Scandinavian Journal of Primary Health Care 29(1). p.57-62
Abstract
Abstract Objective. To evaluate the prevalence of primary aldosteronism (PA) in newly diagnosed and untreated hypertensive patients in primary care using the aldosterone/renin ratio (ARR), and to assess clinical and biochemical characteristics in patients with high and normal ARR. Design. Patient survey study. Setting and subjects. A total of 200 consecutive patients with newly diagnosed and untreated hypertension from six primary health care centres in Sweden were included. Main outcome measures. ARR was calculated from serum aldosterone and plasma renin concentrations. The cut-off level for ARR was 65. Patients with an increased ARR were considered for confirmatory testing with the fludrocortisone suppression test (FST), followed by... (More)
Abstract Objective. To evaluate the prevalence of primary aldosteronism (PA) in newly diagnosed and untreated hypertensive patients in primary care using the aldosterone/renin ratio (ARR), and to assess clinical and biochemical characteristics in patients with high and normal ARR. Design. Patient survey study. Setting and subjects. A total of 200 consecutive patients with newly diagnosed and untreated hypertension from six primary health care centres in Sweden were included. Main outcome measures. ARR was calculated from serum aldosterone and plasma renin concentrations. The cut-off level for ARR was 65. Patients with an increased ARR were considered for confirmatory testing with the fludrocortisone suppression test (FST), followed by adrenal computed tomographic radiology (CT) and adrenal venous sampling (AVS). Results. Of 200 patients, 36 patients had an ARR > 65. Of these 36 patients, 11 patients had an incomplete aldosterone inhibition during FST. Three patients were diagnosed with an aldosterone producing adenoma (APA) and eight with bilateral adrenal hyperplasia (BHA). Except for moderately lower level of P-K in patients with an ARR > 65 and in patients with PA, there were no biochemical or clinical differences found among hypertensive patients with PA compared with patients without PA. Conclusion. Eleven of 200 evaluated patients (5.5%) were considered to have PA. The diagnosis of PA should therefore be considered in newly diagnosed hypertensive subjects and screening for the diagnosis is warranted. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Primary Health Care
volume
29
issue
1
pages
57 - 62
publisher
Taylor & Francis
external identifiers
  • wos:000287403300011
  • pmid:21323498
  • scopus:79951790216
ISSN
0281-3432
DOI
10.3109/02813432.2011.554015
language
English
LU publication?
yes
id
0ae0d916-7438-48ba-b48a-6339fc547ac2 (old id 1831812)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21323498?dopt=Abstract
date added to LUP
2011-03-01 15:30:29
date last changed
2017-08-27 05:44:13
@article{0ae0d916-7438-48ba-b48a-6339fc547ac2,
  abstract     = {Abstract Objective. To evaluate the prevalence of primary aldosteronism (PA) in newly diagnosed and untreated hypertensive patients in primary care using the aldosterone/renin ratio (ARR), and to assess clinical and biochemical characteristics in patients with high and normal ARR. Design. Patient survey study. Setting and subjects. A total of 200 consecutive patients with newly diagnosed and untreated hypertension from six primary health care centres in Sweden were included. Main outcome measures. ARR was calculated from serum aldosterone and plasma renin concentrations. The cut-off level for ARR was 65. Patients with an increased ARR were considered for confirmatory testing with the fludrocortisone suppression test (FST), followed by adrenal computed tomographic radiology (CT) and adrenal venous sampling (AVS). Results. Of 200 patients, 36 patients had an ARR > 65. Of these 36 patients, 11 patients had an incomplete aldosterone inhibition during FST. Three patients were diagnosed with an aldosterone producing adenoma (APA) and eight with bilateral adrenal hyperplasia (BHA). Except for moderately lower level of P-K in patients with an ARR > 65 and in patients with PA, there were no biochemical or clinical differences found among hypertensive patients with PA compared with patients without PA. Conclusion. Eleven of 200 evaluated patients (5.5%) were considered to have PA. The diagnosis of PA should therefore be considered in newly diagnosed hypertensive subjects and screening for the diagnosis is warranted.},
  author       = {Westerdahl, Christina and Bergenfelz, Anders and Isaksson, Anders and Nerbrand, Christina and Valdemarsson, Stig},
  issn         = {0281-3432},
  language     = {eng},
  number       = {1},
  pages        = {57--62},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Primary Health Care},
  title        = {Primary aldosteronism among newly diagnosed and untreated hypertensive patients in a Swedish primary care area.},
  url          = {http://dx.doi.org/10.3109/02813432.2011.554015},
  volume       = {29},
  year         = {2011},
}