Goyal Divyansh, Bhatt Manasvini, Ghosh Tamoghna, Sethi Prayas, Jadon Ranveer Singh, Alam Sarah, Khadgawat Rajesh
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Clin Endocrinol (Oxf). 2025 Oct;103(4):447-455. doi: 10.1111/cen.15296. Epub 2025 Jun 29.
Despite being a leading cause of secondary hypertension and association with a higher incidence of cardiovascular morbidity and mortality the prevalence of primary aldosteronism (PA) is poorly studied.
We assessed the prevalence of PA in participants being treated as essential hypertension (EHTN).
In this prospective, cross-sectional study, 492 participants with diagnosis of EHTN were evaluated. The screening for PA was conducted by measuring plasma aldosterone concentration (PAC) and direct renin concentration (DRC), from which the aldosterone-to-renin ratio (ARR) was calculated. Based on Endocrine Society guidelines, screening test was followed by a confirmatory recumbent saline infusion test (SIT). Participants who showed a post-SIT PAC greater than 5 ng/dL were diagnosed with PA.
Of 492 EHTN participants, 91 (18.49%) had positive screening test. Out of 91 participants, 59 agreed for SIT and PA was confirmed in 37 participants (8.04%) (Excluding 32 screened positive participants who were non-compliant to SIT). The mean age was 49.98 ± 7.76 years, and median duration of hypertension was 5 (0-24) years. The prevalence of PA increased with grade of hypertension (5.97% in grade 1%-12.03% in grade 3), hypertension daily dose (HDD) (3.57% in those with HDD < 1% to 27.27% in those with HDD ≥ 4). No significant difference in hypokalaemia in PA and EHTN (2.70% and 3.54% respectively, p: 0.7815).
Our study shows a high prevalence of PA in subjects treated as a case of EHTN.
尽管原发性醛固酮增多症（PA）是继发性高血压的主要病因之一，且与心血管疾病发病率和死亡率的较高发生率相关，但其患病率的研究尚不充分。
我们评估了被视为原发性高血压（EHTN）患者中PA的患病率。
在这项前瞻性横断面研究中，对492名诊断为EHTN的参与者进行了评估。通过测量血浆醛固酮浓度（PAC）和直接肾素浓度（DRC）进行PA筛查，并计算醛固酮与肾素比值（ARR）。根据内分泌学会指南，筛查试验后进行卧位生理盐水输注试验（SIT）进行确诊。SIT后PAC大于5 ng/dL的参与者被诊断为PA。
在492名EHTN参与者中，91名（18.49%）筛查试验呈阳性。在91名参与者中，59名同意进行SIT，37名参与者（8.04%）确诊为PA（不包括32名筛查阳性但未依从SIT的参与者）。平均年龄为49.98±7.76岁，高血压的中位病程为5（0 - 24）年。PA的患病率随高血压分级增加（1级为5.97% - 3级为12.03%），高血压每日剂量（HDD）增加（HDD＜1%者为3.57% - HDD≥4者为27.27%）。PA和EHTN患者低钾血症无显著差异（分别为2.70%和3.54%，p：0.7815）。
我们的研究表明，在被视为EHTN的患者中PA的患病率较高。
