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Abstract: FR-PO379

Clinical Feature and Diagnosis of Primary Hyperaldosteronism

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Shioda, Ryotaro, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Suzuki, Hitoshi, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Kanaguchi, Yasuhiko, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Gohda, Tomohito, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Suzuki, Yusuke, Juntendo University Faculty of Medicine, Tokyo, Japan
Background

Primary aldosteronism(PA) is the most common form of secondary hypertension, with an estimated prevalence of 10% of hypertensive patients. Patients with PA have higher cardiovascular morbidity and mortality than age- and sex-matched patients with essential hypertension and the same degree of blood pressure elevation. Early checkup is extremely important to prevent cardiovascular event, stroke and renal dysfunction.

Methods

We retrospectively analyzed the clinical features of the patient with PA who were diagnosed from 2014 to 2018.

Results

We analyzed 36 cases with PA who were not treated with RAS inhibitor or diuretic drug at the time of screening test for PA.The average age was 49 years old. The cases of serum K < 3.5 were only 20%, and adrenal adenoma detected by CT scan was 42.9%. The median of aldosterone-to-renin ratio (ARR) was 841.9 (206-4370), however, in cases with adrenal adenoma, the median ARR was significantly high level with 1299.4 (300-4370). The correct diagnostic rate of diagnoses of saline test, furosemide test and captopril test was 77.1, 71.4 and 65.7%, respectively. There was a trend that the accuracy of captopril test was low in patients with low eGFR. The correct diagnostic rate of combination of saline and furosemide tests would be the best. The 90 percentile of the serum potassium in patients with PA was 4.4 mEq/L, however, those in patients with over 40 years old were 4.5 mEq/L.

Conclusion

Present study suggested that screening test for PA should be performed in cases with serum potassium was less than 4.3 mEq/L in hypertensive patients. Especially, in cases with over 40 years old, the screening of the PA with ARR should be performed. In addition, the correct diagnostic rate of diagnoses of captopril test was low compared with other screening test. Combination of salin and furosemide tests suggested to be proposed in present study.