Abstract
BackgroundPrimary aldosteronism (PA) is highly prevalent in hypertensive population. Adrenal vein sampling (AVS) is the only procedure to assess adrenal aldosterone hypersecretion in PA. PA patients without aldosterone-producing adenomas (APA) frequently have unilateral aldosterone hypersecretion (UAH). These patients could bear inappropriate adrenalectomy without AVS. This study aims to identify which clinical characteristics should be recommended to perform AVS in these PA patients.MethodsThis study was performed from January 2018 to July 2019 at a center for hypertension and metabolic diseases. Adrenal computed tomography (CT) scan, biochemical evaluation, and AVS were performed.ResultsTotal 141 patients were included in this study. Aldosterone to renin ratio (ARR) after confirmatory test is highly associated with adrenal laterality. The specificity of ARR > 10 (ng/dL)/(mU/L) after confirmatory test is 100%. After confirmatory test, patients with ARR > 10 (ng/dL)/(mU/L) had higher plasma aldosterone concentration and incidences of ischemic heart diseases and renal damage(p < 0.05).ConclusionsAfter confirmatory tests, ARR > 10 (ng/dL)/(mU/L) indicates adrenal laterality, with increasingly cardiorenal damage in PA patients without APA. Thus, AVS should be recommended in these patients before surgery.Trial registrationNCT03398785, Date of Registration: December 24, 2017.
Highlights
Primary aldosteronism (PA) is highly prevalent in hypertensive population
Study population Of the total 2753 hypertensive patients referred to our center for screening PA from January 2018 to July 2019, we retrospectively reviewed the Adrenal vein sampling (AVS) data of 292 patients who were suspected to have secondary hypertension and excluded 14 patients who failed in AVS, 17 patients with Cushing syndrome / Adrenal medullary hyperplasia, 80 patients with Conn syndrome, and 40 patients without complete biochemical result
Baseline characteristics of patients with AVS subtype According to the presence or absence of lateralization examined by AVS, patients were divided into lateralized PA and non-lateralized PA
Summary
Primary aldosteronism (PA) is highly prevalent in hypertensive population. Adrenal vein sampling (AVS) is the only procedure to assess adrenal aldosterone hypersecretion in PA. PA patients without aldosteroneproducing adenomas (APA) frequently have unilateral aldosterone hypersecretion (UAH). These patients could bear inappropriate adrenalectomy without AVS. Primary aldosteronism (PA) is characterized by excessive aldosterone produced by adrenals. PA is the most common cause of endocrine hypertension and is prevalent in approximately 10–15% in resistant hypertension [1, 2]. Adrenal venous sampling (AVS) is the only procedure to identify UAH; it is available only in few referral centers worldwide because its technique is challenging [11,12,13].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
