Abstract

OBJECTIVES
To estimate the point prevalence of primary hyperaldosteronism in a government out-patient setting and to compare associated patient characteristics with those having essential hypertension.
DESIGN
Case series with external comparison.
SETTING
A single public hospital (Caritas Medical Centre) and all five associated general out-patient clinics in Sham Shui Po district in Hong Kong.
PATIENTS
All patients with confirmed primary hyperaldosteronism and randomly selected patients with essential hypertension from a medical specialist clinic and general out-patient clinics, retrieved from a computer database for the period January 2007 to December 2008.
MAIN OUTCOME MEASURES
Estimated point prevalence of primary hyperaldosteronism among hypertensive patients treated in the public sector of Sham Shui Po district. Patient age when hypertension was diagnosed, number of antihypertensive drugs used for treatment, and the presence of target organ damage in the patients with primary hyperaldosteronism and those with essential hypertension were compared.
RESULTS
Among the 46 012 patients receiving antihypertensive treatment, 49 were confirmed to have primary hyperaldosteronism. The estimated point prevalence of primary hyperaldosteronism among these hypertensive patients was 0.106% only, which was far smaller than figures from other countries. When compared with the 147 patients with essential hypertension by multivariate analysis, those with primary hyperaldosteronism were: (1) associated with longer durations of hypertension (odds ratio=1.14; 95% confidence interval, 1.06-1.24) despite being younger at the time of study, (2) likely to be taking three or more antihypertensive drugs (odds ratio=2.51; 95% confidence interval, 1.59-3.95), and (3) more likely to have left ventricular hypertrophy (odds ratio=5.01; 95% confidence interval, 1.83-13.69). All primary hyperaldosteronism patients studied presented with hypokalaemia. The need for antihypertensive drugs was markedly reduced after adrenalectomy for adrenal adenoma.
CONCLUSIONS
Primary hyperaldosteronism, which is potentially a surgically curable cause of hypertension, appeared to be underdiagnosed in our locality. Screening by aldosterone-renin ratio of high-risk individuals may help improve patient outcomes.

Links

Publisher Full Text

Authors

Sy WM, Fu SN, Luk W, Wong CK, Fung LM

Institution

Department of Family Medicine and Primary Health Care, Kowloon West Cluster, Hong Kong. winniesy@graduate.hku.hk

Source

Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine 18:3 2012 Jun pg 193-200

MeSH

Adrenal Cortex Neoplasms
Adrenalectomy
Adrenocortical Adenoma
Adult
Aged
Aged, 80 and over
Antihypertensive Agents
Asian Continental Ancestry Group
Female
Hong Kong
Humans
Hyperaldosteronism
Hypertension
Male
Middle Aged
Outpatients
Prevalence
Retrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22665682