'Game Changer': Aldosterone-Driven Hypertension More Common Than Thought
Roughly 16%-22% of patients with hypertension appeared to have primary aldosteronism as the likely major cause of their elevated blood pressure, in an analysis of about 1,000 Americans, which is a much higher prevalence than previously appreciated and a finding that could potentially reorient both screening for aldosteronism and management for this subset of patients.
@zenith The study results showed that PA is much more common than previously perceived, and suggest that perhaps PA in milder forms than we typically recognize contributes more to 'essential' hypertension than we previously thought," said Anand Vaidya, MD, senior author of the report and director of the Center for Adrenal Disorders at Brigham and Women's Hospital in Boston. The researchers found adjusted PA prevalence rates of 16% among 115 untreated patients with stage 1 hypertension (130-139/80-89 mm Hg), 22% among 203 patients with untreated stage 2 hypertension (at least 140/90 mm Hg), and 22% among 408 patients with treatment-resistant hypertension. All three prevalence rates were based on relatively conservative criteria that included all 726 patients with hypertension in the analysis (which also included 289 normotensive subjects) regardless of whether or not they also had low levels of serum renin. These PA prevalence rates were also based on a "conservative" definition of PA, a level of at least 12 mcg excreted in a 24-hour urine specimen.