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M. R. Wofford, K. G. Harkins, D. S. King, S. B. Wyatt, D. W. Jones, P-669: Screening for primary aldosterone in older patients with hypertension, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Page 253A, https://doi.org/10.1016/S0895-7061(01)01999-9
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Abstract
The prevalence of primary aldosterone (PA) among hypertensive patients in referral centers is estimated to be 12%. The prevalence of PA among older subjects in referral populations has not been reported. Screening for PA with the plasma aldosterone concentration (PAC; in ng/ml) to plasma renin activity (PRA; in ng/ml/hr) has led to a dramatic increase in detection and treatment of the disorder. A positive screen for PA in our center is a PAC/PRA > 30.
Using an electronic data base we searched medical records for subjects ≥ 60 years old who had a positive PAC/PRA. Subjects were screened if they had resistant hypertension or hypokalemia. Blood pressure measures taken prior to and following initiation of a treatment regimen including a potassium-sparing diuretic are reported.
Forty patients with a mean age of 65 had a positive screen for PA. Fifty-five percent were white; 75% female. (See Table)
. | MEAN . | . | MEAN . |
---|---|---|---|
Potassium | 4.0 | Pre SBP/DBP | 167/91 |
Creatinine | 1.9 | *MAP | 115 |
Aldosterone | 35 | Post SBP/DBP | 143/85 |
Renin | 0.2 | MAP | 99 |
PAC/PRA | 64.8 | *Mean arterial pressure |
. | MEAN . | . | MEAN . |
---|---|---|---|
Potassium | 4.0 | Pre SBP/DBP | 167/91 |
Creatinine | 1.9 | *MAP | 115 |
Aldosterone | 35 | Post SBP/DBP | 143/85 |
Renin | 0.2 | MAP | 99 |
PAC/PRA | 64.8 | *Mean arterial pressure |
. | MEAN . | . | MEAN . |
---|---|---|---|
Potassium | 4.0 | Pre SBP/DBP | 167/91 |
Creatinine | 1.9 | *MAP | 115 |
Aldosterone | 35 | Post SBP/DBP | 143/85 |
Renin | 0.2 | MAP | 99 |
PAC/PRA | 64.8 | *Mean arterial pressure |
. | MEAN . | . | MEAN . |
---|---|---|---|
Potassium | 4.0 | Pre SBP/DBP | 167/91 |
Creatinine | 1.9 | *MAP | 115 |
Aldosterone | 35 | Post SBP/DBP | 143/85 |
Renin | 0.2 | MAP | 99 |
PAC/PRA | 64.8 | *Mean arterial pressure |
PA may be detected in older patients with poorly controlled hypertension. Detection of PA using the PAC/PRA may lead to more effective control in this high-risk population. PA should be considered in the evaluation of resistant hypertension in elderly patients.