EVIDENCE THAT PRIMARY ALDOSTERONISM MAY NOT BE UNCOMMON: 12% INCIDENCE AMONG ANTIHYPERTENSIVE DRUG TRIAL VOLUNTEERS
SUMMARY 1. Six (12%) out of 52 respondents to newspaper advertisements for antihypertensive drug trials had elevated aldosterone to renin ratio, confirmed by repeated measurement. 2. Failure to suppress aldosterone with fludrocortisone acetate administration and oral salt loading confirmed the prese...
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| Veröffentlicht in: | Clinical and experimental pharmacology & physiology 1993-05, Vol.20 (5), p.296-298 |
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| container_title | Clinical and experimental pharmacology & physiology |
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| creator | Gordon, Richard D. Ziesak, Mary D. Tunny, Terry J. Stowasser, Michael Klemm, Shelley A. |
| description | SUMMARY
1. Six (12%) out of 52 respondents to newspaper advertisements for antihypertensive drug trials had elevated aldosterone to renin ratio, confirmed by repeated measurement.
2. Failure to suppress aldosterone with fludrocortisone acetate administration and oral salt loading confirmed the presence of primary aldosteronism in all six patients.
3. Two of the six patients have already had aldosterone‐producing adenomas removed, one has commenced spironolactone, and one has an adrenal mass on computerized tomography but investigation is incomplete.
4. None of the six patients with primary aldosteronism had unprovoked hypokalaemia.
5. Plasma aldosterone levels did not distinguish those patients with subsequently proven primary aldosteronism from the others. Plasma renin activity (PRA) was a better discriminator, but not as good as the aldosterone to renin ratio.
6. The incidence of primary aldosteronism is probably much higher than the 1% currently quoted in texts, with earlier, normokalaemic forms accounting for the majority of cases. |
| doi_str_mv | 10.1111/j.1440-1681.1993.tb01687.x |
| format | Article |
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1. Six (12%) out of 52 respondents to newspaper advertisements for antihypertensive drug trials had elevated aldosterone to renin ratio, confirmed by repeated measurement.
2. Failure to suppress aldosterone with fludrocortisone acetate administration and oral salt loading confirmed the presence of primary aldosteronism in all six patients.
3. Two of the six patients have already had aldosterone‐producing adenomas removed, one has commenced spironolactone, and one has an adrenal mass on computerized tomography but investigation is incomplete.
4. None of the six patients with primary aldosteronism had unprovoked hypokalaemia.
5. Plasma aldosterone levels did not distinguish those patients with subsequently proven primary aldosteronism from the others. Plasma renin activity (PRA) was a better discriminator, but not as good as the aldosterone to renin ratio.
6. The incidence of primary aldosteronism is probably much higher than the 1% currently quoted in texts, with earlier, normokalaemic forms accounting for the majority of cases.</description><identifier>ISSN: 0305-1870</identifier><identifier>EISSN: 1440-1681</identifier><identifier>DOI: 10.1111/j.1440-1681.1993.tb01687.x</identifier><identifier>PMID: 8324912</identifier><identifier>CODEN: CEXPB9</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; aldosterone ; Aldosterone - blood ; aldosterone-producing adenoma ; Arterial hypertension. Arterial hypotension ; bilateral hyperplasia ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Female ; Fludrocortisone ; Humans ; Hyperaldosteronism - complications ; Hyperaldosteronism - diagnosis ; Hyperaldosteronism - epidemiology ; hypertension ; Hypertension - complications ; incidence ; Male ; Medical sciences ; Middle Aged ; potassium ; primary aldosteronism ; renin ; Renin - blood</subject><ispartof>Clinical and experimental pharmacology & physiology, 1993-05, Vol.20 (5), p.296-298</ispartof><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3516-62756956bbea923bff7b4ba65f6e90f4d15b78dc5c24e7f8d2d0aae26edc74ec3</citedby><cites>FETCH-LOGICAL-c3516-62756956bbea923bff7b4ba65f6e90f4d15b78dc5c24e7f8d2d0aae26edc74ec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1440-1681.1993.tb01687.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1440-1681.1993.tb01687.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>309,310,314,777,781,786,787,1412,23911,23912,25121,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4711095$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8324912$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gordon, Richard D.</creatorcontrib><creatorcontrib>Ziesak, Mary D.</creatorcontrib><creatorcontrib>Tunny, Terry J.</creatorcontrib><creatorcontrib>Stowasser, Michael</creatorcontrib><creatorcontrib>Klemm, Shelley A.</creatorcontrib><title>EVIDENCE THAT PRIMARY ALDOSTERONISM MAY NOT BE UNCOMMON: 12% INCIDENCE AMONG ANTIHYPERTENSIVE DRUG TRIAL VOLUNTEERS</title><title>Clinical and experimental pharmacology & physiology</title><addtitle>Clin Exp Pharmacol Physiol</addtitle><description>SUMMARY
1. Six (12%) out of 52 respondents to newspaper advertisements for antihypertensive drug trials had elevated aldosterone to renin ratio, confirmed by repeated measurement.
2. Failure to suppress aldosterone with fludrocortisone acetate administration and oral salt loading confirmed the presence of primary aldosteronism in all six patients.
3. Two of the six patients have already had aldosterone‐producing adenomas removed, one has commenced spironolactone, and one has an adrenal mass on computerized tomography but investigation is incomplete.
4. None of the six patients with primary aldosteronism had unprovoked hypokalaemia.
5. Plasma aldosterone levels did not distinguish those patients with subsequently proven primary aldosteronism from the others. Plasma renin activity (PRA) was a better discriminator, but not as good as the aldosterone to renin ratio.
6. The incidence of primary aldosteronism is probably much higher than the 1% currently quoted in texts, with earlier, normokalaemic forms accounting for the majority of cases.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>aldosterone</subject><subject>Aldosterone - blood</subject><subject>aldosterone-producing adenoma</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>bilateral hyperplasia</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</subject><subject>Female</subject><subject>Fludrocortisone</subject><subject>Humans</subject><subject>Hyperaldosteronism - complications</subject><subject>Hyperaldosteronism - diagnosis</subject><subject>Hyperaldosteronism - epidemiology</subject><subject>hypertension</subject><subject>Hypertension - complications</subject><subject>incidence</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>potassium</subject><subject>primary aldosteronism</subject><subject>renin</subject><subject>Renin - blood</subject><issn>0305-1870</issn><issn>1440-1681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1993</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkMuOmzAUhlHVapqZ9hEqWVU7O6iNsQ2zqESJmyBxicBJlZVlwEikZDLFiZp5-xIFZV9vjuz_4qPPsj4j6KDxfNs5yPOgjaiPHBQE2DlWcLww5_zGmt2kt9YMYkhs5DP43ro3ZgchJJDiO-vOx64XIHdmGb6J5zyLOBDLUIBVEadhsQVhMs9LwYs8i8sUpOEWZLkAPzhYZ1Gepnn2BJD7FcRZNKXD8W0BwkzEy-2KF4JnZbzhYF6sF0AUcZiATZ6sM8F5UX6w3rWqN_rjNB-s9U8uoqWd5Is4ChO7xgRRm7qM0IDQqtIqcHHVtqzyKkVJS3UAW69BpGJ-U5Pa9TRr_cZtoFLapbqpmadr_GA9XntfhsOfkzZHue9MrftePevDyUhGfA9R7I3Gp6uxHg7GDLqVL0O3V8OrRFBeiMudvGCVF6zyQlxOxOV5DH-afjlVe93cohPiUf8y6crUqm8H9Vx35mbzGEIwIKPt-9X2t-v1638sICO-cgM6FtjXgs4c9flWoIbfkjLMiPyVLSQtkCh935cF_gc87aNa</recordid><startdate>199305</startdate><enddate>199305</enddate><creator>Gordon, Richard D.</creator><creator>Ziesak, Mary D.</creator><creator>Tunny, Terry J.</creator><creator>Stowasser, Michael</creator><creator>Klemm, Shelley A.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199305</creationdate><title>EVIDENCE THAT PRIMARY ALDOSTERONISM MAY NOT BE UNCOMMON: 12% INCIDENCE AMONG ANTIHYPERTENSIVE DRUG TRIAL VOLUNTEERS</title><author>Gordon, Richard D. ; Ziesak, Mary D. ; Tunny, Terry J. ; Stowasser, Michael ; Klemm, Shelley A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3516-62756956bbea923bff7b4ba65f6e90f4d15b78dc5c24e7f8d2d0aae26edc74ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1993</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>aldosterone</topic><topic>Aldosterone - blood</topic><topic>aldosterone-producing adenoma</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>bilateral hyperplasia</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</topic><topic>Female</topic><topic>Fludrocortisone</topic><topic>Humans</topic><topic>Hyperaldosteronism - complications</topic><topic>Hyperaldosteronism - diagnosis</topic><topic>Hyperaldosteronism - epidemiology</topic><topic>hypertension</topic><topic>Hypertension - complications</topic><topic>incidence</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>potassium</topic><topic>primary aldosteronism</topic><topic>renin</topic><topic>Renin - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gordon, Richard D.</creatorcontrib><creatorcontrib>Ziesak, Mary D.</creatorcontrib><creatorcontrib>Tunny, Terry J.</creatorcontrib><creatorcontrib>Stowasser, Michael</creatorcontrib><creatorcontrib>Klemm, Shelley A.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental pharmacology & physiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gordon, Richard D.</au><au>Ziesak, Mary D.</au><au>Tunny, Terry J.</au><au>Stowasser, Michael</au><au>Klemm, Shelley A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>EVIDENCE THAT PRIMARY ALDOSTERONISM MAY NOT BE UNCOMMON: 12% INCIDENCE AMONG ANTIHYPERTENSIVE DRUG TRIAL VOLUNTEERS</atitle><jtitle>Clinical and experimental pharmacology & physiology</jtitle><addtitle>Clin Exp Pharmacol Physiol</addtitle><date>1993-05</date><risdate>1993</risdate><volume>20</volume><issue>5</issue><spage>296</spage><epage>298</epage><pages>296-298</pages><issn>0305-1870</issn><eissn>1440-1681</eissn><coden>CEXPB9</coden><abstract>SUMMARY
1. Six (12%) out of 52 respondents to newspaper advertisements for antihypertensive drug trials had elevated aldosterone to renin ratio, confirmed by repeated measurement.
2. Failure to suppress aldosterone with fludrocortisone acetate administration and oral salt loading confirmed the presence of primary aldosteronism in all six patients.
3. Two of the six patients have already had aldosterone‐producing adenomas removed, one has commenced spironolactone, and one has an adrenal mass on computerized tomography but investigation is incomplete.
4. None of the six patients with primary aldosteronism had unprovoked hypokalaemia.
5. Plasma aldosterone levels did not distinguish those patients with subsequently proven primary aldosteronism from the others. Plasma renin activity (PRA) was a better discriminator, but not as good as the aldosterone to renin ratio.
6. The incidence of primary aldosteronism is probably much higher than the 1% currently quoted in texts, with earlier, normokalaemic forms accounting for the majority of cases.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>8324912</pmid><doi>10.1111/j.1440-1681.1993.tb01687.x</doi><tpages>3</tpages></addata></record> |
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| ispartof | Clinical and experimental pharmacology & physiology, 1993-05, Vol.20 (5), p.296-298 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Aged, 80 and over aldosterone Aldosterone - blood aldosterone-producing adenoma Arterial hypertension. Arterial hypotension bilateral hyperplasia Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Clinical manifestations. Epidemiology. Investigative techniques. Etiology Female Fludrocortisone Humans Hyperaldosteronism - complications Hyperaldosteronism - diagnosis Hyperaldosteronism - epidemiology hypertension Hypertension - complications incidence Male Medical sciences Middle Aged potassium primary aldosteronism renin Renin - blood |
| title | EVIDENCE THAT PRIMARY ALDOSTERONISM MAY NOT BE UNCOMMON: 12% INCIDENCE AMONG ANTIHYPERTENSIVE DRUG TRIAL VOLUNTEERS |
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