Screening for primary aldosteronism in hypertensive subjects: results from two German epidemiological studies
Screening for primary aldosteronism in hypertensive subjects: results from two German epidemiological studies
复制标题
DOI：
10.1530/eje-11-1013
复制
发表时间：
2012-07-01
影响因子：
5.8
通讯作者：
Reincke, M.
中科院分区：
文献类型：
--
作者：
Hannemann, A.;Bidlingmaier, M.;Reincke, M.
目的：原发性醛固酮增多症在高血压患者中的患病率目前尚不清楚。我们调查了两项德国流行病学研究中年龄在30-79岁的高血压受试者中基于醛固酮与肾素比值（ARR）的原发性醛固酮增多症阳性筛查结果的频率。我们进一步研究了频率的积极筛查结果在受试者与顽固性高血压或III期高血压和未治疗和治疗的高血压subjects.Methods之间可能存在的差异：数据来自第一次随访的人口为基础的研究健康在波美拉尼亚（SHIP; n=1392）和合作健康研究在奥格斯堡地区（KORA; n=1052）。采用研究特定的血浆醛固酮浓度（PAC）、血浆肾素浓度（PRC）和ARR参考范围。在这些流行病学研究中未进行原发性醛固酮增多症的确认试验。结果：A、B、C三种定义的筛查阳性率分别为7.0%、3.8%、0.2%。在顽固性高血压（11.9、5.5和0.9%）或III期高血压（18.3、14.0和1.1%）受试者亚组中，这些频率明显高于一般高血压人群。治疗和未治疗的高血压subjects.Conclusions之间的阳性筛查结果的频率没有差异：在德国的高血压人群中最多7.0%的原发性醛固酮增多症的阳性筛查结果。因此，原发性醛固酮增多症的发生率可能低于先前基于转诊高血压患者数据的预期。
Objective: The prevalence of primary aldosteronism in unselected hypertensive patients is currently unknown. We investigated the frequency of positive screening results for primary aldosteronism based on the aldosterone-to-renin ratio (ARR) in hypertensive subjects aged 30-79 years from two German epidemiological studies. We further examined the frequency of positive screening results in subjects with resistant hypertension or stage III hypertension and assessed possible disparities between untreated and treated hypertensive subjects.Methods: Data were obtained from the first follow-ups of the population-based Study of Health in Pomerania (SHIP; n=1392) and the Cooperative Health Research in the Region of Augsburg (KORA; n=1052). Study-specific reference ranges for plasma aldosterone concentration (PAC), plasma renin concentration (PRC) and the ARR were applied. Confirmation tests for primary aldosteronism were not performed in these epidemiological studies. Three definitions for a positive screening for primary aldosteronism were applied: A) increased ARR; B) increased ARR and decreased PRC; and C) increased ARR and increased PAC and decreased PRC.Results: The frequency of positive screening results was 7.0, 3.8 and 0.2% according to definitions A-C respectively. In the subgroups of subjects with resistant hypertension (11.9, 5.5 and 0.9%) or stage III hypertension (18.3, 14.0 and 1.1%), these frequencies were markedly higher than those in the general hypertensive population. There was no difference in the frequency of positive screening results between the treated and untreated hypertensive subjects.Conclusions: A maximum of 7.0% of the hypertensive population in Germany shows a positive screening result for primary aldosteronism. Thus, primary aldosteronism may be less frequent than previously expected based on data from referred hypertensive patients.