Jefic Dijana, Mohiuddin Naushaba, Alsabbagh Rana, Fadanelli Margaret, Steigerwalt Susan
Department of Medicine, St. John Hospital and Medical Center, 22201 Moross Road, Detroit, MI 48236, USA.
J Clin Hypertens (Greenwich). 2006 Apr;8(4):253-6. doi: 10.1111/j.1524-6175.2005.05251.x.
Increased plasma aldosterone concentrations (PACs) are associated with higher cardiovascular risk and target organ damage (TOD). Hyperglycemia can potentiate the cellular effects of aldosterone, and the prevalence of diabetes in primary aldosteronism (PA) is 7%-59%. The prevalence of PA in hypertensive individuals is estimated to be 10%-14%. This study of 61 hypertensive diabetic patients not taking spironolactone and with serum creatinine values <2.5 mg/dL sought to establish the prevalence of PA in hypertensive diabetics and compare the prevalence of PA in patients with TOD with those patients without TOD. PA was suspected if PACs were >15 ng/dL and plasma renin activity was <1 ng/dL/h (ratio >30). Although 14 patients had suppressed renin with PACs >8 ng/dL (including two with PACs >11 ng/dL), none met our criteria for PA. There was no correlation between PAC and TOD. This study indicates that routine screening for PA in hypertensive diabetic patients is not justified and that PAC does not correlate with TOD. Further study is needed.
血浆醛固酮浓度（PACs）升高与较高的心血管风险和靶器官损害（TOD）相关。高血糖可增强醛固酮的细胞效应，原发性醛固酮增多症（PA）患者中糖尿病的患病率为7% - 59%。据估计，高血压患者中PA的患病率为10% - 14%。本研究纳入了61例未服用螺内酯且血清肌酐值<2.5 mg/dL的高血压糖尿病患者，旨在确定高血压糖尿病患者中PA的患病率，并比较有TOD的患者和无TOD的患者中PA的患病率。如果PACs>15 ng/dL且血浆肾素活性<1 ng/dL/h（比值>30），则怀疑为PA。虽然有14例患者的肾素受到抑制且PACs>8 ng/dL（包括2例PACs>11 ng/dL的患者），但无一例符合我们的PA标准。PAC与TOD之间无相关性。本研究表明，对高血压糖尿病患者进行PA的常规筛查是不合理的，且PAC与TOD不相关。需要进一步研究。
