Prevalence of primary aldosteronism in hypertensive subjects with hyperglycaemia

Abstract

Objective: Recent studies have reported higher prevalence of primary aldosteronism (PA) than ever before in patients with hypertensive, and hyperglycaemia is common in hypertensives. It is unknown, however, if the prevalence of PA was higher in hypertensive patients with hyperglycemia, including diabetes mellitus (DM), impaired glucose tolerant (IGT) and impaired fasting glucose (IFG). The aim of this study was to examine the prevalence of PA in this special group. Methods: A total of 232 adult subjects with hypertension and hyperglycaemia were screened for PA. Subjects with a plasma aldosterone concentration to plasma rennin activity ratio (ARR) above 20 underwent confirmatory saline loading testing which is as confirmative test for PA. Results: 66 subjects (28.4%) had an ARR above 20(ng/dL per ng/mL/h), of which 54 subjects with suspected PA underwent saline loading testing. PA was present in 22.4% (plasma aldosterone concentration >5 ng/dl) and in 11.6% in total subjects (plasma aldosterone concentration >10 ng/dL in total subjects). And it was at least 14.0–23.0% in the DM group, 2.3–23.3% in the IGT group, and 9.1% in the IFG group, respectively. Conclusion: PA is common in patients with hypertension complicated with hyperglycaemia. In Chinese, significant numbers of hypertensive individuals with hyperglycaemia may be subclinical forms of PA, and these special subjects should be screened for primary aldosteronism.