Screening of Hyperaldosteronism on the Investigation of Secondary Hypertension: Single-centre Experience

Abstract

Introduction:Primary hyperaldosteronism (PHA), is a clinical syndrome that is defined as inappropriately increased serum aldosterone secretion and low plasma renin levels. PHA has been reported as the most common cause of secondary hypertension. In this retrospective study, we planned to show the significance of screening for this disease in hypertensive patients admitted to our clinic.Methods:Our study included 64 patients who were admitted to our cardiology outpatient clinic between April 2018 and August 2021 with high blood pressure and were selected to be checked for plasma renin activity (PRA), PAC, and PAC/PRA ratios to exclude secondary hypertension. Medical records, hypertension treatments, and medical histories of the patients were reviewed from our hospital database.Results:Of the 64 patients, 25 (39.1%) were female and 39 (60.9%) were male. After the first evaluation of the patients, 13 patients were decided to be assessed with the saline infusion test. PHA was diagnosed in 7 of 13 patients evaluated. In the adrenal MRI performed in 3 of 7 patients diagnosed with PHA, one adrenal hyperplasia and one adrenal adenoma were diagnosed in 2 different patients.Conclusion:Primary hyperaldosteronism is one of the most important causes of secondary hypertension. Although there are various methods such as screening tests, the most commonly used method is the aldosterone/renin ratio and it is very practical to screen. Considering the various cardiovascular diseases that PHA is associated with, and the simplicity of treatment of PHA, we strongly believe that the screening threshold for PHA should be kept as low as possible and should be independent of age.

Keywords

• hyperaldosteronism
• secondary hypertension
• renin