Objective: Hypokalemic Conns syndrome is a rare disease with a prevalence of 0.5% in unselected hypertensive populations. However, recent studies indicate a higher prevalence of a milder variant of Conns syndrome, reaching 10% in some studies. Long term outcome and health care costs of hypo- and normokalemic variants are largely unknown. The National Conns Registry is an initiative to create a national database of sufficient epidemiological strength to investigate co-morbidity and mortality in these patients.
Methods: The registry has at present 7 participating centres in 5 locations and uses an electronic database to assure comparison of different centres. Since 07/2006 retrospective data were included in the database from patients with Conns syndrome diagnosed between 1990 and 2007.
Results: Evaluation of the retrospective data entry provide the following results: Of the 726 patients (60.4±13.7 years, range 696 years), 54.3% had the hypokalemic variant of the disease. The mean RR was 158±29 mmHg systolic and 94±16 mmHg diastolic. Morbidity of cerebrovascular events (TIA, PRIND, stroke) in the overall cohort was high with 9.6% of patients. The prevalence of cardiovascular morbidity (angina pectoris, myocardial infarction, coronary angioplasty) was 13.5% in our cohort. Atrial fibrillation occurred in 8.4% of the patients and other atrial or ventricular dysrhythmia in 5.5% of the patients. Chronic renal failure was present in 10.9% of patients, and sleep apnea in 8.1% of patients. Overall co-morbidities were more frequent in hypokalemic than in normokalemic individuals.
Conclusion: Our data show high proportion co-morbidites for Conns syndrome, which is endorsed by previous results from France describing a 34 fold higher prevalence of stroke, myocardial infarction and atrial fibrillation in a small cohort of primary aldosteronism (n=124) compared to patients with essential hypertension (n=465). In addition, our data demonstrate evidence that the hypokalemic variant of Conns syndrome has a higher morbidity than the normokalemic variant.
03 - 07 May 2008
European Society of Endocrinology