关键词: 醛固酮增多症, 高血压, 肾素, 醛固酮腺瘤, 单侧肾上腺增生

Abstract:

[Abstract]   Objective   To study the detection rate and characteristics of primary aldosteronism (PA) in patients with
hypertension.  Methods   A total of197patients with hypertension were enrolled and underwent PA and other related examination to exclude the secondary hypertension. Patients were divided into two groups: PA group and essential hypertension (EH) group. The upright position test, supine position test, captopril test, venous high sodium test, potassium concentration examination and adrenal CTscanningwere detected in two groups. Values of blood aldosterone, renin activity and aldosterone to renin activity ratio (ARR) were detected in some patients.   Results   (1) In 197hypertensive patients,38were diagnosed as PA (19.29%),13were confirmed by pathology, (6cases aldosterone-producing adenoma and7unilateral adrenal hyperplasia). (2) There were no significant differences in the history of hypertension and body mass index (BMI) between two groups. There were more male patients than female patients in both groups. (3) Compared with EH group, there were relatively young age of onset, higher levels of systolic and diastolic blood pressure in PA group, but the difference was not statistically significant (P＞0.05). The levels of blood aldosterone and ARR were significantly increased in upright position and supine position in PA group (P＜0.01), but the blood level of renin activity was significantly decreased(P＜0.01). There was no significant significance in blood potassium level between two groups.  Conclusion   There was a higher detection rate of PA in patients hospitalized with hypertension. The detection rate of aldosterone-producing adenoma was similar to that of unilateral adrenal hyperplasia in patients with PA. The hypokalemia was uncommon.

Key words: hyperaldosteronism, hypertension, rennin, aldosterone-producing adenoma, unilateral adrenal hyperplasia