頑固性高血壓患者中原發性醛固酮增多症的患病率：一項回顧性觀察研究

頑固性高血壓患者中原發性醛固酮增多症的患病率：一項回顧性觀察研究 Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study Douma S, Petidis K, Doumas M| 2009/5/31 18:19:25| Lancet| 2008| View at Publisher 專家評級： | 循證評級： B| 【全球專家評論】| 列印| 推薦給好友 上一篇： 腎素－血管緊張素系統阻斷治療以及較低的血壓控制目標對非裔美國黑人高血壓導致的慢性腎病進展的長期影響 下一篇： 頑固性高血壓：診斷、評估及治療：來自美國心臟協會職業教育委員會高血壓研究顧問委員會的一項學術聲明 Background: Results of several studies published since 1999 suggest that primary hyperaldosteronism (also known as Conn"s syndrome) affects more than 10% of people with hypertension; however, such a high prevalence has also been disputed. Experts generally agree that resistant hypertension has the highest prevalence of primary hyperaldosteronism, on the basis of small studies. We aimed to assess the prevalence of primary hyperaldosteronism in a large group of patients with resistant hypertension.Methods: Patients with resistant hypertension (blood pressure >140/90mmHg despite a three drug regimen, including a diuretic) who attended our outpatient clinic were assessed for primary hyperaldosteronism. Serum aldosterone and plasma renin activity were determined and their ratio was calculated. Patients with a positive test (ratio >65·16 and aldosterone concentrations >416pmol/L) underwent salt suppression tests with intravenous saline and fludrocortisone. Diagnosis of primary hyperaldosteronism was further confirmed by the response to treatment with spironolactone.
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