Primary Aldosteronism in Patients in China With Recently Detected Hypertension

Zhixin Xu, Jun Yang, Jinbo Hu, Ying Song, Wenwen He, Ting Luo, Qingfeng Cheng, Linqiang Ma, Rong Luo, Peter J. Fuller, Jun Cai, Qifu Li, Shumin Yang, for the Chongqing Primary Aldosteronism Study (CONPASS) Group

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6 Citations (Scopus)

Abstract

Background: A total of 44.7% adults in China have hypertension, but the prevalence of primary aldosteronism (PA) in Chinese hypertensive patients is unknown. Objectives: This study prospectively investigated the prevalence, characteristics, and outcomes of PA in newly diagnosed hypertensive patients. Methods: In a large community health center, consecutive hypertensive patients with an aldosterone-renin ratio >20 ng/mIU and plasma aldosterone concentration >10 ng/dl underwent captopril challenge test and/or saline infusion test for confirmation of PA. Adrenal computed tomography scan and adrenal vein sampling were used for subtyping. PA patients treated with surgery or medication were followed up for 1 year, and outcomes after treatment were evaluated. Results: In total, 1,020 newly diagnosed hypertensive patients were screened over 16 months, of whom 40 were diagnosed with PA, 948 with non-PA, 32 with probable PA, resulting in a prevalence of more than 4.0%. Compared with non-PA, PA patients more frequently displayed microalbuminuria (p = 0.031), but the incidence of cardiovascular events was not different (p = 0.927). For surgically treated patients (n = 7), a complete biochemical success rate was 100% and a complete clinical success rate was 85.7%. For medically treated patients (n = 29), the proportion with optimal blood pressure control was 79%, and among them, 91% (21 of 23) only needed 1 antihypertensive drug: the mineralocorticoid receptor antagonist. Conclusions: The prevalence of PA in patients with newly diagnosed hypertension in China was at least 4%. PA screening in newly diagnosed hypertensive patients leads to good clinical outcomes. (Primary Aldosteronism In Hypertensive Patients in China [PA-China]; NCT03155139)

Original languageEnglish
Pages (from-to)1913-1922
Number of pages10
JournalJournal of the American College of Cardiology
Volume75
Issue number16
DOIs
Publication statusPublished - 28 Apr 2020

Keywords

  • clinical outcome
  • newly diagnosed hypertension
  • prevalence
  • primary aldosteronism

Cite this

Xu, Z., Yang, J., Hu, J., Song, Y., He, W., Luo, T., Cheng, Q., Ma, L., Luo, R., Fuller, P. J., Cai, J., Li, Q., Yang, S., & for the Chongqing Primary Aldosteronism Study (CONPASS) Group (2020). Primary Aldosteronism in Patients in China With Recently Detected Hypertension. Journal of the American College of Cardiology, 75(16), 1913-1922. https://doi.org/10.1016/j.jacc.2020.02.052