Prevalence of primary aldosteronism in Chinese patients with resistant hypertension
W. Wang, Y. Jiang, X. Sang, T. Su, B. Cui, J. Ye, J. Cai, J. He, C. Liu & G. Ning
Background: Studies across the world have unveiled different prevalence of primary aldosteronism (PA) in distinct geographical areas and human races. However, owing to disparities in methodology and recruitment, the true incidence is still open. Especially information in Asian resistant hypertension is rare, so we determined to investigate the prevalence of PA in this population.
Methods: We launched a large-scale, hospital-based national survey and enrolled 1656 patients with resistant hypertension finally. Serum aldosterone and plasma renin activity were measured in every subject and ARR (aldosterone-to-renin ratio) was calculated to screen PA. Positive patient ARR>20 underwent intravenous saline infusion test, and diagnosis of PA was established if post-saline aldosterone was above 8 ng/dl.
Results: Among 1656 patients with resistant hypertension, 494 (29.8%) were screened positive on the basis of ARR>20 and underwent intravenous saline infusion. The diagnosis of PA was established in 118 (7.1%) subjects according to an unsuppressed post-saline aldosterone (>8 ng/dl). Prevalence of PA decreases with aging and so do aldosterone and renin activity level. Data show no significant gender difference in prevalence, however, women intrinsically have lower PRA level and thus higher ARR, due to which some screening strategies may require further modification.
Conclusion: The prevalence of primary aldosteronism in Chinese patients with resistant hypertension is relatively lower compared with previously reported data from other populations.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.