Primary hyperaldosteronism in essential hypertensives: Prevalence, biochemical profile, and molecular biology

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dc.contributor.authorFardella, CE
dc.contributor.authorMosso, L
dc.contributor.authorGomez Sanchez, C
dc.contributor.authorCortes, P
dc.contributor.authorSoto, J
dc.contributor.authorGomez, L
dc.contributor.authorPinto, M
dc.contributor.authorHuete, A
dc.contributor.authorOestreicher, E
dc.contributor.authorForadori, A
dc.contributor.authorMontero, J
dc.date.accessioned2024-08-15T08:00:08Z
dc.date.available2024-08-15T08:00:08Z
dc.date.issued2000
dc.description.abstractThere is evidence that primary aldosteronism (PA) may be common in patients with essential hypertension (EH) when determinations of serum aldosterone (SA), plasma renin activity(PRA), and the SA/PRA ratio are used as screening. An inherited form of primary hyperaldosteronism is the glucocorticoid-remediable aldosteronism (GRA) caused by an unequal crossing over between the CYP11B1 and CYP11B2 genes that results in a chimeric gene, which has aldosterone synthase activity regulated by ACTH. The aim of this study was to evaluate the prevalence of PA and the GRA in 305 EH patients and 205 normotensive controls. We measured SA (1-16 ng/dL) and PRA (1-2.5 ng/mL . h) and calculated the SA/PRA ratio in all patients. A SA/PRA ratio level greater than 25 was defined as being elevated. PA was diagnosed in the presence of high SA levels (>16 ng/dL), low PRA levels (<0.5 ng/mL . h), and very high SA/PRA ratio (>50). Probable PA was diagnosed when the SA/PRA ratio was more than 25 but the other criteria were not present. A Fludrocortisone test was done to confirm the diagnosis. GRA was differentiated from other forms of PA by: the aldosterone suppression test with dexamethasone, the high levels of 18-hydroxycortisol, and the genetic detection of the chimeric gene. In EH patients, 29 of 305 (9.5%) had PA, 13 of 29 met all the criteria for PA, and 16 of 29 were initially diagnosed as having a probable PA and confirmed by the fludrocortisone test. Plasma potassium was normal in all patients. The dexamethasone suppression test was positive for GRA in 10 of 29 and 18-hydroxycortisol levels were high in 2 of 29 patients who had also a chimeric gene. In normotensive subjects, 3 of 205 (1.46%) had PA, and 1 of 205 had a GRA. In summary, we found a high frequency of normokalemic PA in EH patients. A high proportion of PA suppressed SA with dexamethasone, but only a few had a chimeric gene or high levels of 18-hydroxycortisol. These results emphasize the need to further investigate EH patients.
dc.format.extent5 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1210/jc.85.5.1863
dc.identifier.eissn1945-7197
dc.identifier.issn0021-972X
dc.identifier.pubmedidMEDLINE:10843166
dc.identifier.scopusidSCOPUS_ID:0033155140
dc.identifier.urihttps://doi.org/10.1210/jc.85.5.1863
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/87445
dc.identifier.wosidWOS:000088387300023
dc.information.autorucFacultad de Medicina; Mosso Gomez, Lorena Montserrat; S/I; 88201
dc.issue.numero5
dc.language.isoen
dc.nota.accesoSin adjunto
dc.pagina.final1867
dc.pagina.inicio1863
dc.revistaJOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
dc.rightsregistro bibliográfico
dc.subjectPLASMA-RENIN-ACTIVITY
dc.subjectGLUCOCORTICOID-REMEDIABLE ALDOSTERONISM
dc.subjectSTEROID 11-BETA-HYDROXYLASE
dc.subjectACTIVITY RATIO
dc.subjectDIAGNOSIS
dc.subject18-OXOCORTISOL
dc.subjectBIOSYNTHESIS
dc.subjectSYNTHASE
dc.subjectGENE
dc.subject18-HYDROXYCORTISOL
dc.titlePrimary hyperaldosteronism in essential hypertensives: Prevalence, biochemical profile, and molecular biology
dc.typeartículo
dc.volumen85
sipa.codpersvinculados88201
sipa.indexWOS
sipa.indexPubmed
sipa.trazabilidadCarga WOS-SCOPUS;15-08-2024
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