Prevalence of primary aldosteronism without hypertension in the general population: Results in Shika study

Karashima, Shigehiro; Kometani, Mitsuhiro; Tsujiguchi, Hiromasa; Asakura, Hiroki; Nakano, Shigeru; Usukura, Mikiya; Mori, Shunsuke; Ohe, Masashi; Sawamura, Toshitaka; Okuda, Rika; Hara, Akinori; Takamura, Toshinari; Yamagishi, Masakazu; Nakamura, Hiroyuki; Takeda, Yoshiyu; Yoneda, Takashi

doi:10.6084/m9.figshare.5221486

iceh_a_1339072_sm1957.docx (1.97 MB)

Prevalence of primary aldosteronism without hypertension in the general population: Results in Shika study

journal contribution

posted on 2017-07-19, 17:23 authored by Shigehiro Karashima, Mitsuhiro Kometani, Hiromasa Tsujiguchi, Hiroki Asakura, Shigeru Nakano, Mikiya Usukura, Shunsuke Mori, Masashi Ohe, Toshitaka Sawamura, Rika Okuda, Akinori Hara, Toshinari Takamura, Masakazu Yamagishi, Hiroyuki Nakamura, Yoshiyu Takeda, Takashi Yoneda

Objective: Recent studies have reported a high prevalence of primary aldosteronism (PA) among hypertensive patients. However, few data exist regarding the prevalence of PA in the general population. Therefore, we examined the prevalence of PA in the general population including normotensive subjects. Methods: Plasma renin activity (ng/mL/hr), plasma aldosterone concentration (pg/mL) and aldosterone renin ratio (ARR) were determined in 309 subjects aged >40 years in Horimatsu and Higashi-Matsuho district, Shika-machi, Ishikawa, Japan. Results: Among them, 195 subjects (78 males, mean age: 62 ± 11 years) did not take antihypertensive agents: 113 normotensive subjects and 82 hypertensive subjects. Under these conditions, 68 subjects (13 males, age 62 ± 10 years) had an ARR >200. In 14 subjects who underwent captopril suppression test, PA was documented in 5 subjects, yielding a minimum prevalence of 2.6% in total subjects (1.8% in normotensive subjects and 3.7% in hypertensive subjects). Interestingly, females subjects demonstrated significant differences in ARR between subjects with age <50 (172 ± 105) and those with age 51–60 (388 ± 531), although there were no differences in male subjects. Conclusions: These results demonstrate that PA including normotensive subjects exists more commonly than that expected in the general population. We suggest further investigation about the cause and progression of PA associated with sex and aging.