High frequency of primary hyperaldosteronism among hypertensive patients from a primary care area in Sweden

Objective. To search for primary hyperaldosteronism (PHA) among previously known hypertensive patients in primary care, using the aldosterone/renin ratio (ARR), and to evaluate clinical and biochemical characteristics in patients with high or normal ratio. Design. Patient survey study. Setting and s...

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Bibliographic Details
Published in:Scandinavian journal of primary health care 2006, Vol.24 (3), p.154-159
Main Authors: Westerdahl, Christina, Bergenfelz, Anders, Isaksson, Anders, Wihl, Anders, Nerbrand, Christina, Valdemarsson, Stig
Format: Article
Language:English
Subjects:
Aged
Aldosterone
Aldosterone - blood
aldosterone to renin ratio
family practice
Fludrocortisone
Health Care Service and Management, Health Policy and Services and Health Economy
Health Sciences
Humans
Hyperaldosteronism - blood
Hyperaldosteronism - diagnosis
Hyperaldosteronism - epidemiology
Hyperaldosteronism - etiology
Hypertension
Hypertension - blood
Hypertension - diagnosis
Hypertension - epidemiology
Hypertension - etiology
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
Hälsovetenskap
Inhibition
Medical and Health Sciences
Medicin och hälsovetenskap
Middle Aged
Primary health care
primary hyperaldosteronism
renin
Renin - blood
Serum
Suppression
Sweden
Sweden - epidemiology
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Summary:Objective. To search for primary hyperaldosteronism (PHA) among previously known hypertensive patients in primary care, using the aldosterone/renin ratio (ARR), and to evaluate clinical and biochemical characteristics in patients with high or normal ratio. Design. Patient survey study. Setting and subjects. The study population was recruited by written invitation among hypertensive patients in two primary care areas in Sweden. A total of 200 patients met the criteria and were included in the study. Main outcome measures. The ARR was calculated from serum aldosterone and plasma renin concentrations. The cut-off level for ARR was set to 100, as confirmed in 28 healthy subjects. Patients with increased ARR were considered for a confirmatory test, using the fludrocortisone suppression test. Results. Of 200 patients, 50 patients had ARR > 100; 26 patients were further evaluated by fludrocortisone suppression test. Seventeen of these patients had an incomplete aldosterone inhibition. Conclusion. In total 17 of 200 evaluated patients (8.5%) had an incomplete suppression with fludrocortisone. This confirms previous reports on a high frequency of PHA. No significant biochemical or clinical differences were found among hypertensive patients with PHA compared with the whole sample.
ISSN:0281-3432
1502-7724
DOI:10.1080/02813430600830931