Original InvestigationCardiovascular complications in patients with primary aldosteronism★
Section snippets
Methods
During the 19-year period from 1977 to 1996, 58 patients with PA caused by unilateral adenoma (Conn's syndrome) were admitted to the National Cardiovascular Center Hospital (Osaka, Japan). The diagnosis of PA was based on an elevated plasma aldosterone concentration/renin activity ratio that was unresponsive to a captopril test and on computed tomographic scans of the adrenal grand. It was confirmed by histological analysis of the removed adenoma after unilateral adrenalectomy in 47 patients.
Results
The clinical characteristics of the studied patients with PA are listed in Table 1.
NOTE. Values expressed as mean ± standard deviation or number of patients.Parameter Empty Cell Age (yr) 45 ± 9 Sex (men/women) 31/27 Known duration of hypertension (yr) 7.4 ± 6.5 Body mass index (kg/m2) 22.8 ± 3.4
Discussion
It has been widely believed that PA is a benign type of hypertension with a low incidence of cardiovascular complications. Therefore, it has been emphasized that hypertensive patients with low plasma renin activity, as in PA, had fewer cardiovascular complications than those with normal and elevated plasma renin activity.2, 3 However, several studies showed cardiovascular complications were not rare in PA.4, 5, 6 In the present study, we found cardiovascular complications in 34% of the patients
Acknowledgements
Acknowledgment: The authors thank Keiko Tanegashima for her excellent secretarial work.
References (43)
- et al.
Clinical characteristics of primary aldosteronism from an analysis of 145 cases
Am J Surg
(1964) Vasoconstriction-volume analysis for understanding and treating hypertension: The use of renin and aldosterone profiles
Am J Med
(1973)- et al.
Sodium sensitivity and cardiovascular events in patients with essential hypertension
Lancet
(1997) - et al.
The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads
Am Heart J
(1949) - et al.
Renal function reserve and sodium sensitivity in essential hypertension
J Lab Clin Med
(1996) - et al.
Does microalbuminuria predict cardiovascular events in nondiabetic men with treated hypertension? Risk Factor Intervention Study Group
Am J Hypertens
(1995) - et al.
Dippers and non-dippers
Lancet
(1988) - et al.
Essential hypertension: Renin and aldosterone, heart attack and stroke
N Engl J Med
(1972) - et al.
Renal abnormalities and vascular complications in primary hyperaldosteronism. Evidence on tertiary hyperaldosteronism
Q J Med
(1976) - et al.
Hypertensive complications in patients with primary aldosteronism. A retrospective study
Curr Ther Res
(1991)
Vascular complications in patients with aldosterone-producing adenoma in Japan: Comparative study with essential hypertension. The Research Committee of Disorders of Adrenal Hormones in Japan
J Endocrinol Invest
Albuminuria in untreated patients with primary aldosteronism or essential hypertension
J Hypertens
A case report of aldosterone-producing adrenocortical adenoma complicated with chronic renal failure associated with nephrocalcinosis: Review of APAs complicated with chronic renal failure
Folia Endocrinol
Renal function curve in patients with secondary forms of hypertension
Hypertension
High sodium sensitivity and glomerular hypertension/hyperfiltration in primary aldosteronism
J Hypertens
Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method
Circulation
The renal basis for salt sensitivity in hypertension
Indirect assessment of glomerular capillary pressure from pressure-natriuresis relationship: Comparison with direct measurements reported in rats
Hypertens Res
Role of abnormally high transmural pressure in the permselectivity defect of glomerular capillary wall: A study in early passive Heymann nephritis
Circ Res
Microalbuminuria in salt-sensitive patients. A marker for renal and cardiovascular risk factors
Hypertension
Hyperinsulinemic microalbuminuria. A new risk indicator for coronary heart disease
Circulation
Cited by (0)
Received February 13, 1998; accepted in revised form August 14, 1998.
Supported by in part by grants no. C-1995-3 and A-1997-9 from Research Grants for Cardiovascular Diseases and for Scientific Research Expenses for Health and Welfare Programs and Funds for Comprehensive Research on Long-Term Chronic Disease (Renal Failure) from the Ministry of Health and Welfare of Japan; grants from Salt Science Research Foundation, Tokyo; Japan Cardiovascular Research Foundation; and Takeda Science Foundation, Osaka.
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Address reprint requests to Genjiro Kimura, MD, Chief, Division of Nephrology, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan. E-mail: [email protected]