| Prevalence of primary hyperaldosteronism in mild to moderate hypertension without hypokalaemia. | |
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MedLine Citation:
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PMID: 16292348 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Screening for primary hyperaldosteronism (PHA) is often indicated in individuals with resistant hypertension or hypokalaemia. However, in the far larger subset of the hypertensive population who do not fit into these criteria, the evidence for screening is conflicting and dependent on the disease prevalence. The purpose of this study was to examine the prevalence of PHA in a large population with mild to moderate hypertension and without hypokalaemia using a carefully controlled study protocol including a normotensive control population. Hypertensive subjects underwent medication washout and both hypertensive and normotensive subjects placed on a high-sodium diet prior to biochemical and haemodynamic testing. Study specific cutoff values were based on results from the normotensive population studied under identical conditions. A screening test (serum aldosterone/PRA ratio [ARR]>25 with a serum aldosterone level >8 ng/dl) was followed by a confirmatory test (urine aldosterone excretion rate [AER] >17 microg/24 h) to demonstrate evidence of PHA. An elevated ARR with a concomitant elevated serum aldosterone was present in 26 (7.5%) individuals. Of these, 11 (3.2%) had an elevated AER, consistent with evidence of PHA. Individuals with PHA had higher blood pressure and lower serum potassium levels while on a high-sodium diet. Sodium restriction neutralized these differences between PHA and essential hypertensives. The prevalence of PHA in this mild to moderate hypertensive population without hypokalaemia is at most 3.2%, a rate that might lead to excessive false positives with random screening in comparable populations. Hyperaldosteronism, when present, is responsive to sodium restriction. |
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Authors:
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J S Williams; G H Williams; A Raji; X Jeunemaitre; N J Brown; P N Hopkins; P R Conlin |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Journal of human hypertension Volume: 20 ISSN: 0950-9240 ISO Abbreviation: J Hum Hypertens Publication Date: 2006 Feb |
Date Detail:
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Created Date: 2006-01-19 Completed Date: 2006-04-20 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8811625 Medline TA: J Hum Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 129-36 Citation Subset: IM |
Affiliation:
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Department of Medicine, Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. Jwilliams5@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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African Continental Ancestry Group Aldosterone / blood, urine Cross-Over Studies Female Humans Hyperaldosteronism / blood, complications, epidemiology*, urine Hypertension / complications* Hypokalemia Male Mass Screening Middle Aged Potassium / urine Renin / blood Sodium, Dietary / administration & dosage*, urine |
| Grant Support | |
ID/Acronym/Agency:
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DK63214/DK/NIDDK NIH HHS; HL47651/HL/NHLBI NIH HHS; HL55000/HL/NHLBI NIH HHS; HL59424/HL/NHLBI NIH HHS; HL77234/HL/NHLBI NIH HHS; M01 RR 00064/RR/NCRR NIH HHS; M01 RR 02635/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Sodium, Dietary; 52-39-1/Aldosterone; 7440-09-7/Potassium; EC 3.4.23.15/Renin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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