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Primary aldosteronism in a general population sample. The Czech post-MONICA study.
Widimský, Jirí; Bruthans, Jan; Wohlfahrt, Peter; Krajcoviechová, Alena; Sulc, Pavel; Linhart, Ales; Filipovský, Jan; Lánská, Vera; Cífkova, Renata.
Afiliação
  • Widimský J; Department of Medicine III, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
  • Bruthans J; Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
  • Wohlfahrt P; Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
  • Krajcoviechová A; Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
  • Sulc P; Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
  • Linhart A; Department of Medicine II, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
  • Filipovský J; Department of Medicine II, Faculty of Medicine, Charles University, Pilsen, Czech Republic.
  • Lánská V; Medical Statistics Unit, Institute for Experimental and Clinical Medicine, Prague, Czech Republic.
  • Cífkova R; Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
Blood Press ; 29(3): 191-198, 2020 06.
Article em En | MEDLINE | ID: mdl-32036692
ABSTRACT

Purpose:

Primary aldosteronism (PA) is considered the most common form of secondary hypertension, however, its prevalence, particularly in a general population, is still a matter of debate. The aim of our study was to evaluate the prevalence of PA in a randomly selected general population sample.Materials and

methods:

A total of 1940 individuals (1% population random sample) aged 25-64 years were screened for major cardiovascular risk factors in six districts of the Czech Republic. Hypertension was defined as a mean of two blood pressure readings ≥140/90 mmHg at one visit or taking antihypertensive medication. Within this population, 740 individuals were labelled as hypertensives and 650 of them sampled for the analysis of direct plasma renin and serum aldosterone. The diagnosis of PA was based on elevated serum aldosterone, low plasma renin and high aldosterone/renin (ARR) ratio and was also verified by a confirmatory test with saline infusion.

Results:

Positive ARR was found in 52 (8%) individuals (64% women, 36% men, however, due to substatntial proportion of reluctatnt participants to undergo a further work-up (27%), we could confirm the diagnosis of PA only in 13 of them (2%). Aldosterone-producing adenoma was found in one case only, seven patients had idiopathic type and five individuals refused potential surgical treatment therefore, adrenal venous sampling was not performed.

Conclusion:

Elevated serum aldosterone together with low renin and high ARR were found in 52 (8%) of hypertensives selected from a general population sample, however, the diagnosis of PA was confirmed only in 13 of them (2%). This study based on a general population survey highlighted the difficulty of conducting epidemiological studies on primary aldosteronism in a relatively healthy cohort part of whom did not provide the level of collaboration that is necessary to assess the true prevalence of this condition.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hiperaldosteronismo / Hipertensão Tipo de estudo: Diagnostic_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Blood Press Assunto da revista: ANGIOLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: República Tcheca

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hiperaldosteronismo / Hipertensão Tipo de estudo: Diagnostic_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Blood Press Assunto da revista: ANGIOLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: República Tcheca