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High Prevalence of Primary Aldosteronism Observed

Adjusted prevalence estimates of aldosteronism increase in parallel with hypertension severity

TUESDAY, May 26, 2020 (HealthDay News) — Primary aldosteronism is prevalent and increases in parallel with hypertension severity, according to a study published online May 26 in the Annals of Internal Medicine.

Jenifer M. Brown, M.D., from Harvard Medical School in Boston, and colleagues characterized the prevalence of nonsuppressible renin-independent aldosterone production and biochemically overt primary aldosteronism in relation to blood pressure in a cross-sectional study. Data were included for 289 participants with normotension, 115 with stage 1 hypertension, 203 with stage 2 hypertension, and 408 with resistant hypertension.

The researchers observed a continuum of renin-independent aldosterone production in every blood pressure category, where a greater severity of production was associated with elevated blood pressure, kaliuresis, and lower serum potassium levels. The mean adjusted levels of urinary aldosterone were 6.5, 7.3, 9.5, and 14.6 µg/24 hours in normotension, stage 1 hypertension, stage 2 hypertension, and resistant hypertension, respectively; for biochemically overt primary aldosteronism, the corresponding adjusted prevalence estimates were 11.3, 15.7, 21.6, and 22.0 percent. Poor sensitivity and negative predictive value for detecting biochemically overt primary aldosteronism were seen for the aldosterone-renin ratio.

“These findings support the need to redefine primary aldosteronism from a rare and categorical disease to, instead, a common syndrome that manifests across a broad severity spectrum and may be a primary contributor to hypertension pathogenesis,” the authors write.

One author disclosed financial ties to the biopharmaceutical industry.

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