Oral Salt Loading Test is Associated With 24-Hour Blood Pressure and Organ Damage in Primary Aldosteronism Patients
Oral Salt Loading Test is Associated With 24-Hour Blood Pressure and Organ Damage in Primary Aldosteronism Patients
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DOI：
10.1210/jendso/bvaa116
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发表时间：
2020-10-01
影响因子：
4.1
通讯作者：
Shibata, Hirotaka
中科院分区：
文献类型：
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作者：
Yoshida, Yuichi;Yoshimura, Saki;Shibata, Hirotaka
目的：在本研究中，我们通过评估24小时血压（BP）、尿白蛋白、左心室质量（LVM）和内膜中层厚度（IMT），调查了反映原发性醛固酮增多症（PA）严重程度的最有用的确证性试验。该研究包括113名患者（80名PA和33名非PA高血压患者），他们入住大分大学医院，并使用动态血压监测（ABPM）进行评估。首先，比较PA和非PA患者的偶然血压（BP）和ABPM参数。然后根据生理盐水输注试验（SIT）、开搏通激发试验（CCT）、口服盐负荷试验（OBT）等验证性试验将患者分为PA阳性组和PA阴性组，比较2组患者的随机血压和动态血压监测（ABPM）参数。此外，尿白蛋白排泄，左心室质量，最大IMT作为器官damage.Results指标进行了比较：ABPM参数，但不是偶然的血压，PA患者高于非PA患者。OSLT阳性患者的夜间和24小时收缩压（SBP）显著高于OSLT阴性患者。PA阳性组和PA阴性组在其他确证性试验中的ABPM参数无差异。OSLT阳性患者的尿白蛋白排泄量显著高于OSLT阴性患者。然而，在其他验证性试验中，器官损伤标志物没有不同的2 groups.Conclusion：Ostrophin是潜在的有用的，不仅用于PA的诊断，但也用于评估24小时收缩压和器官损伤，如尿白蛋白排泄。
Objective: In the present study, we investigated the most useful confirmatory test for reflecting the severity of primary aldosteronism (PA), by evaluating 24-hour blood pressure (BP), urine albumin, left ventricular mass (LVM), and intima media thickness (IMT).Methods: This study included 113 patients (80 PA and 33 non-PA hypertensive patients) who were admitted to Oita University Hospital and evaluated using ambulatory blood pressure monitoring (ABPM). First, casual blood pressure (BP) and ABPM parameters were compared between PA and non-PA patients. Second, patients were divided into PA-positive and PA-negative groups based on confirmatory tests, including the saline infusion test (SIT), captopril challenge test (CCT), and oral salt loading test (OSLT), and casual BP and ABPM parameters were compared between the 2 groups. In addition, urine albumin excretion, LVM, and maximum IMT as markers of organ damage were compared between the 2 groups.Results: The ABPM parameters but not casual BP, were higher in PA patients than in non-PA patients. Nocturnal and 24-hour systolic BP (SBP) in OSLT-positive patients were significantly higher than in OSLT negative patients. ABPM parameters in other confirmatory tests were not different between the PA-positive and PA-negative groups. Urine albumin excretion in OSLT-positive patients was significantly higher than in the OSLT-negative patients. However, in other confirmatory tests, organ damage markers were not different between the 2 groups.Conclusion: The OSLT is potentially useful not only for the diagnosis of PA but also for assessment of 24-hour SBP and organ damage, as indicated by urine albumin excretion.