Primary aldosteronism in diabetic subjects with resistant hypertension.

Primary aldosteronism in diabetic subjects with resistant hypertension. Research Abstract Details 

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Primary aldosteronism in diabetic subjects with resistant hypertension. Abstract Text:

Guillermo E Umpierrez,Paul Cantey,Dawn Smiley,Andres Palacio,Diana Temponi,Karen Luster,Arlene Chapman,Guillermo E Umpierrez,Paul Cantey,Dawn Smiley,Andres Palacio,Diana Temponi,Karen Luster,Arlene Chapman,Guillermo E Umpierrez,Paul Cantey,Dawn Smiley,Andres Palacio,Diana Temponi,Karen Luster,Arlene Chapman,

OBJECTIVE: Despite the high prevalence of hypertension in patients with type 2 diabetes, the prevalence of primary aldosteronism in this population has not been determined. RESEARCH DESIGN AND METHODS: One hundred subjects with type 2 diabetes and resistant hypertension, defined as blood pressure > 140/90 mmHg despite the use of > or = 3 antihypertensive agents, were screened for primary aldosteronism. Screening was performed by measuring the plasma aldosterone (PAC)-to-plasma renin activity (PRA) ratio. Subjects with a PAC-to-PRA ratio > 30 ng x ml(-1) x h(-1) underwent confirmatory salt load testing. Diagnostic criteria included 24-h urine aldosterone > or = 12 microg during the 3rd day of the oral salt load or a PAC > or = 5 ng/dl after the 4-h intravenous saline load. RESULTS: Thirty-four subjects had a PAC-to-PRA ratio >30 ng x ml(-1) x h(-1). Fourteen subjects (14% [95% CI 7.2-20.8]) had a confirmed diagnosis of primary aldosteronism. Ninety-three patients were African Americans. There were no differences in age, glycemic control, and number of antihypertensive drugs between subjects with and without primary aldosteronism. Subjects with primary aldosteronism had lower serum potassium (3.7 +/- 0.4 vs. 4.0 +/- 0.4 mmol/l, P = 0.012), higher PAC (15.6 +/- 8 vs. 9.1 +/- 6 ng/dl, P = 0.0016), and higher PAC-to-PRA ratio (98 +/- 74 vs. 21 +/- 30 x ml(-1) x h(-1), P < 0.001) than patients without primary aldosteronism. CONCLUSIONS: Primary aldosteronism is common in diabetic patients with resistant hypertension, with a prevalence of 14%. Our results indicate that diabetic subjects with poorly controlled hypertension who are taking > or = 3 antihypertensive drugs should be screened for primary aldosteronism.

Primary aldosteronism in diabetic subjects with resistant hypertension. Publishing Authors By Initials

GE Umpierrez,P Cantey,D Smiley,A Palacio,D Temponi,K Luster,A Chapman,GE Umpierrez,P Cantey,D Smiley,A Palacio,D Temponi,K Luster,A Chapman,GE Umpierrez,P Cantey,D Smiley,A Palacio,D Temponi,K Luster,A Chapman,

For similar investigative techniques: epidemiologic methods: data collection: vital statistics: morbidity: prevalence research abstracts see: investigative techniques: epidemiologic methods: data collection: vital statistics: morbidity: prevalence research

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Primary aldosteronism in diabetic subjects with resistant hypertension. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Diabetes care

VOLUME: 30

Page Numbers: 1699-703

Journal Abbreviation: Diabetes Care

ISSN: 1935-5548

DAY: 11

MONTH: 04

YEAR: 2007

Primary aldosteronism in diabetic subjects with resistant hypertension. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 7805975

Primary aldosteronism in diabetic subjects with resistant hypertension. Keywords Mesh Terms:

KEYWORDS: Prevalence

MESH TERMS: etiology

Chemical & Substance for Abstract: Primary aldosteronism in diabetic subjects with resistant hypertension. Information

Substance Name: Antihypertensive Agents

Registry Number: 0

Grant and Affiliation Information for Primary aldosteronism in diabetic subjects with resistant hypertension.

AFFILIATION: Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30303, USA. geumpie@emory.edu

Country: United States

AGENCY: United States NIDDK

GRANT: R03 DK073190-01

ACRONYM: DK

MEDLINETA: Diabetes Care

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