Changes in the clinical manifestations of primary aldosteronism.
10.3904/kjim.2014.29.2.217
- Author:
Sun Hwa KIM
1
;
Jae Hee AHN
;
Ho Cheol HONG
;
Hae Yoon CHOI
;
Yoon Jung KIM
;
Nam Hoon KIM
;
Hye Jin YOO
;
Hee Young KIM
;
Ji A SEO
;
Nan Hee KIM
;
Sin Gon KIM
;
Kyung Mook CHOI
;
Sei Hyun BAIK
;
Dong Seop CHOI
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. cdongs@kumc.or.kr
- Publication Type:Original Article ; Comparative Study
- Keywords:
Hyperaldosteronism;
Hypertension;
Hypokalemia
- MeSH:
Adrenal Cortex Neoplasms/diagnosis/epidemiology;
Adrenal Glands/radiography;
Adrenocortical Adenoma/diagnosis/epidemiology;
Adult;
Biological Markers/blood;
Female;
Humans;
Hyperaldosteronism/blood/*diagnosis/epidemiology/therapy;
Hyperkalemia/diagnosis/epidemiology;
Hyperplasia;
Hypertension/diagnosis/epidemiology;
Male;
Middle Aged;
Potassium/blood;
Predictive Value of Tests;
Prevalence;
Republic of Korea/epidemiology;
Retrospective Studies;
Risk Factors;
Time Factors;
Tomography, X-Ray Computed;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2014;29(2):217-225
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Primary aldosteronism (PA) is now widely recognized to have a higher prevalence than was once thought. In view of its increasing prevalence, we compared chronological changes in clinical manifestations of PA according to different times of diagnosis. METHODS: In total, 85 patients diagnosed with PA from January 1986 through March 2012 were reviewed retrospectively, based on their medical records. During two periods-1986 to 2005 and 2006 to 2012-41 and 44 patients, respectively, were diagnosed with PA. We compared the clinical and biological characteristics of PA between these periods. RESULTS: The results demonstrate an increasing trend in the prevalence of idiopathic hyperaldosteronism (IHA; p = 0.19). In the 2006 to 2012 period, patients with PA presented with higher serum potassium levels at the time of diagnosis than in the 1986 to 2005 period (p < 0.0002). Adrenal vein sampling (AVS) was performed mostly in the latter period (82.3%) and the diagnostic accuracy of adrenal computed tomography, compared with AVS, was only 56.2%. About 78.0% versus 86.3% of patients had at least one target organ damage (TOD) in the 1986 to 2005 and 2006 to 2012 periods, respectively (p = 0.39). However, patients with TOD were older and had longer durations of hypertension than patients without, in both periods. CONCLUSIONS: PA is becoming more prevalent. There was an increasing tendency for IHA, and more PA patients presented with normokalemia than in the earlier period. Early and accurate diagnosis of PA with AVS and proper treatment should have substantial prognostic value.
