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Primary Hyperaldosteronism in Essential Hypertensives: Prevalence, Biochemical Profile, and Molecular Biology1

Fardella, Carlos E., Mosso, Lorena, Gómez-Sánchez, Celso, Cortés, Paola, Soto, Julia, Gómez, Luis, Pinto, Mauricio, Huete, Alvaro +3 more·2000·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem.85.5.6596
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Abstract

There is evidence that primary aldosteronism (PA) may be common in patients with essential hypertension (EH) when determinations of serum aldosterone (SA), plasma renin activity (PRA), and the SA/PRA ratio are used as screening. An inherited form of primary hyperaldosteronism is the glucocorticoid-remediable aldosteronism (GRA) caused by an unequal crossing over between the CYP11B1 and CYP11B2 genes that results in a chimeric gene, which has aldosterone synthase activity regulated by ACTH. The aim of this study was to evaluate the prevalence of PA and the GRA in 305 EH patients and 205 normotensive controls. We measured SA (1-16 ng/dL) and PRA (1-2.5 ng/mL x h) and calculated the SA/PRA ratio in all patients. A SA/PRA ratio level greater than 25 was defined as being elevated. PA was diagnosed in the presence of high SA levels (>16 ng/dL), low PRA levels ( 50). Probable PA was diagnosed when the SA/PRA ratio was more than 25 but the other criteria were not present. A Fludrocortisone test was done to confirm the diagnosis. GRA was differentiated from other forms of PA by: the aldosterone suppression test with dexamethasone, the high levels of 18-hydroxycortisol, and the genetic detection of the chimeric gene. In EH patients, 29 of 305 (9.5%) had PA, 13 of 29 met all the criteria for PA, and 16 of 29 were initially diagnosed as having a probable PA and confirmed by the fludrocortisone test. Plasma potassium was normal in all patients. The dexamethasone suppression test was posit…

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Authors
Fardella, C. E., Mosso, L., Gómez-Sánchez, C., Cortés, P., Soto, J., Gómez, L., Pinto, M., Huete, A., Oestreicher, E., Foradori, A., & Montero, J.
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2000-05
Volume
85
Issue
5
Pages
1863-1867
ISSN
  • 0021-972X
  • 1945-7197
DOI
10.1210/jcem.85.5.6596
Cited by
14
References
7
Language
en

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