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Prevalence and clinical characteristics of primary aldosteronism in a tertiary-care center in Korea

Abstract

Approximately 29% of Korean adults have hypertension; however, the prevalence of primary aldosteronism among the hypertensive population is largely unknown. The aim of our study was to evaluate the prevalence and clinical characteristics of primary aldosteronism in a tertiary-care center in Korea. We retrospectively analyzed 1173 patients with newly diagnosed or preexisting hypertension who were referred to our tertiary-care hospital between January 2013 and December 2018. Patients were screened for primary aldosteronism with the aldosterone-renin ratio and underwent a saline infusion test for diagnostic confirmation. Adrenal computed tomography and adrenal venous sampling were performed for subtype classification for primary aldosteronism. Among the 1173 patients (mean age, 51.8 years; women, 53.2%), 360 (30.7%) had positive screening-test results, of whom 71 (6.1%) were finally diagnosed with primary aldosteronism. Conclusive subtype differentiation was made in 55 patients, of whom 15 (27%) had an aldosterone-producing adenoma, 4 (7%) had unilateral adrenal hyperplasia, and 36 (66%) had bilateral adrenal hyperplasia. Patients with primary aldosteronism had a higher ambulatory blood pressure, left ventricular mass index, and urinary albumin-to-creatinine ratio than those without. Moreover, the primary aldosteronism group had a higher prevalence of left ventricular hypertrophy and albuminuria than the non-primary aldosteronism group. Primary aldosteronism may be more common (6.1%) among Korean patients with hypertension than generally recognized. Primary aldosteronism was associated with a higher degree and prevalence of target organ damage and a higher blood pressure level. Wide application of screening tests for primary aldosteronism may be beneficial in detecting this potentially curable cause of hypertension.

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Acknowledgements

This research was supported by a Research Program (2021-ER0903-00) funded by the Korea Disease Control and Prevention Agency.

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Correspondence to Yumie Rhee or Sungha Park.

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Conflict of interest

CJL has received honoraria from Novartis, Daewoong Pharmaceutical, Servier, Hanmi Pharmaceutical, Yuhan, Boryung Pharmaceutical, and Daiichi Sankyo. YR has received an honorarium from Amgen and has been a consultant for Amgen and Pharmanovia. SP has received honoraria from Pfizer, Boryoung, Hanmi, Daewoong, Donga, Celltrion, Servier, Daiichi Sankyo, and Daewon. SP has also received a research grant from Daiichi Sankyo. The remaining authors have nothing to declare.

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Yoon, M., Hong, N., Ha, J. et al. Prevalence and clinical characteristics of primary aldosteronism in a tertiary-care center in Korea. Hypertens Res 45, 1418–1429 (2022). https://doi.org/10.1038/s41440-022-00948-7

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  • DOI: https://doi.org/10.1038/s41440-022-00948-7

Keywords

  • Ambulatory blood pressure monitoring
  • Hypertension
  • Primary aldosteronism
  • Target-organ damage

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