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

 Minjae Yoon  ;  Namki Hong  ;  Jaehyung Ha  ;  Chan Joo Lee  ;  Cheol Ryong Ku  ;  Yumie Rhee  ;  Sungha Park 
 HYPERTENSION RESEARCH, Vol.45(9) : 1418-1429, 2022-09 
Journal Title
Issue Date
Adult ; Aldosterone ; Blood Pressure Monitoring, Ambulatory ; Female ; Humans ; Hyperaldosteronism* / complications ; Hyperaldosteronism* / diagnosis ; Hyperaldosteronism* / epidemiology ; Hyperplasia / complications ; Hypertension* / complications ; Middle Aged ; Prevalence ; Renin ; Retrospective Studies ; Tertiary Care Centers
Ambulatory blood pressure monitoring ; Hypertension ; Primary aldosteronism ; Target-organ damage
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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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Cheol Ryong(구철룡) ORCID logo https://orcid.org/0000-0001-8693-9630
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Yoon, Minjae(윤민재)
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Lee, Chan Joo(이찬주) ORCID logo https://orcid.org/0000-0002-8756-409X
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
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