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EVIDENCE THAT PRIMARY ALDOSTERONISM MAY NOT BE UNCOMMON: 12% INCIDENCE AMONG ANTIHYPERTENSIVE DRUG TRIAL VOLUNTEERS
Author(s) -
Gordon Richard D.,
Ziesak Mary D.,
Tunny Terry J.,
Stowasser Michael,
Klemm Shelley A.
Publication year - 1993
Publication title -
clinical and experimental pharmacology and physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 103
eISSN - 1440-1681
pISSN - 0305-1870
DOI - 10.1111/j.1440-1681.1993.tb01687.x
Subject(s) - primary aldosteronism , medicine , antihypertensive drug , incidence (geometry) , drug , pharmacology , aldosterone , blood pressure , physics , optics
SUMMARY 1. Six (12%) out of 52 respondents to newspaper advertisements for antihypertensive drug trials had elevated aldosterone to renin ratio, confirmed by repeated measurement. 2. Failure to suppress aldosterone with fludrocortisone acetate administration and oral salt loading confirmed the presence of primary aldosteronism in all six patients. 3. Two of the six patients have already had aldosterone‐producing adenomas removed, one has commenced spironolactone, and one has an adrenal mass on computerized tomography but investigation is incomplete. 4. None of the six patients with primary aldosteronism had unprovoked hypokalaemia. 5. Plasma aldosterone levels did not distinguish those patients with subsequently proven primary aldosteronism from the others. Plasma renin activity (PRA) was a better discriminator, but not as good as the aldosterone to renin ratio. 6. The incidence of primary aldosteronism is probably much higher than the 1% currently quoted in texts, with earlier, normokalaemic forms accounting for the majority of cases.