Primary aldosteronism was present in at least 4.0% of newly diagnosed hypertensive patients in China, and targeted treatment led to high rates of blood pressure control.
Observational (n=1,020)
No
What is the prevalence and clinical outcome of primary aldosteronism in newly diagnosed hypertensive patients in China?
The prevalence of primary aldosteronism in newly diagnosed hypertensive patients in China is at least 4%, and systematic screening followed by targeted treatment yields high rates of blood pressure control and clinical success.
BACKGROUND A total of 44.7% adults in China have hypertension, but the prevalence of primary aldosteronism (PA) in Chinese hypertensive patients is unknown. OBJECTIVES This study prospectively investigated the prevalence, characteristics, and outcomes of PA in newly diagnosed hypertensive patients. METHODS In a large community health center, consecutive hypertensive patients with an aldosterone-renin ratio >20 ng/mIU and plasma aldosterone concentration >10 ng/dl underwent captopril challenge test and/or saline infusion test for confirmation of PA. Adrenal computed tomography scan and adrenal vein sampling were used for subtyping. PA patients treated with surgery or medication were followed up for 1 year, and outcomes after treatment were evaluated. RESULTS In total, 1,020 newly diagnosed hypertensive patients were screened over 16 months, of whom 40 were diagnosed with PA, 948 with non-PA, 32 with probable PA, resulting in a prevalence of more than 4.0%. Compared with non-PA, PA patients more frequently displayed microalbuminuria (p = 0.031), but the incidence of cardiovascular events was not different (p = 0.927). For surgically treated patients (n = 7), a complete biochemical success rate was 100% and a complete clinical success rate was 85.7%. For medically treated patients (n = 29), the proportion with optimal blood pressure control was 79%, and among them, 91% (21 of 23) only needed 1 antihypertensive drug: the mineralocorticoid receptor antagonist. CONCLUSIONS The prevalence of PA in patients with newly diagnosed hypertension in China was at least 4%. PA screening in newly diagnosed hypertensive patients leads to good clinical outcomes. (Primary Aldosteronism In Hypertensive Patients in China PA-China; NCT03155139).
Xu et al. (Wed,) conducted a observational in Newly diagnosed hypertension (n=1,020). Primary aldosteronism vs. Non-primary aldosteronism was evaluated on Prevalence of primary aldosteronism. Primary aldosteronism was present in at least 4.0% of newly diagnosed hypertensive patients in China, and targeted treatment led to high rates of blood pressure control.
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