Document Detail


Clinical and biochemical characteristics of normotensive patients with primary aldosteronism: a comparison with hypertensive cases.
MedLine Citation:
PMID:  18284637     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: It is unknown why some patients with biochemical evidence of primary aldosteronism (PA) do not develop hypertension. We aimed to compare clinical and biochemical characteristics of normotensive and hypertensive patients with PA. DESIGN AND PATIENTS: Retrospective comparison of 10 normotensive and 168 hypertensive patients with PA for office or ambulatory blood pressure, serum potassium, plasma aldosterone and renin concentrations; the aldosterone:renin ratio, and tumour size. Comparison of initial hormonal pattern and drop in blood pressure following adrenalectomy in five normotensive and nine hypertensive patients matched for age, sex and body mass index. RESULTS: The 10 normotensive patients were women and presented with hypokalemia or an adrenal mass. Age, plasma aldosterone and renin concentrations were similar in normotensive and hypertensive cases, but kalemia and body mass index were significantly lower in the normotensive patients. Mean tumour diameter was larger in the normotensive patients than in the hypertensive matched patients with an adenoma (P < 0.01). In normotensive patients, diastolic blood pressure and upright aldosterone correlated negatively with kalemia. Blood pressure was lowered similarly after adrenalectomy in five normotensive PA patients and in their matched hypertensive counterparts. Aldosterone synthase expression was detected in four out of five adrenal tumours. CONCLUSIONS: Blood pressure may be normal in patients with well-documented PA. The occurrence of hypokalemia, despite a normal blood pressure profile, suggests that protective mechanisms against hypertension are present in normotensive patients.
Authors:
Virginie Médeau; François Moreau; Ludovic Trinquart; Maud Clemessy; Jean-Louis Wémeau; Marie Christine Vantyghem; Pierre-François Plouin; Yves Reznik
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-07-01
Journal Detail:
Title:  Clinical endocrinology     Volume:  69     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-07     Completed Date:  2009-07-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  England    
Other Details:
Languages:  eng     Pagination:  20-8     Citation Subset:  IM    
Affiliation:
Département d'Hypertension, AP-HP, Hôpital Européen Georges Pompidou, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / complications,  genetics,  metabolism
Adrenalectomy
Adrenocortical Adenoma / complications,  genetics,  metabolism
Adult
Aldosterone Synthase / genetics,  metabolism
Biological Markers / analysis*,  metabolism
Blood Pressure / physiology*
Case-Control Studies
Female
Follow-Up Studies
Humans
Hyperaldosteronism / complications,  etiology,  genetics,  physiopathology*
Hypertension / complications*,  genetics,  metabolism
Male
Middle Aged
Retrospective Studies
Steroid 11-beta-Hydroxylase / genetics,  metabolism
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; EC 1.14.15.4/Aldosterone Synthase; EC 1.14.15.4/Steroid 11-beta-Hydroxylase

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