Korean J Intern Med.  2014 Mar;29(2):217-225. 10.3904/kjim.2014.29.2.217.

Changes in the clinical manifestations of primary aldosteronism

• Kim SH
• Ahn JH
• Hong HC
• Choi HY
• Kim YJ
• Kim NH
• Yoo HJ
• Kim HY
• Seo JA
• Kim NH
• Kim SG
• Choi KM
• Baik SH
• Choi DS

• KMID: 1792038
• DOI: http://doi.org/10.3904/kjim.2014.29.2.217

Abstract

BACKGROUND/AIMS
Primary aldosteronism (PA) is now widely recognized to have a higher prevalence than was once thought. In view of its increasing prevalence, we compared chronological changes in clinical manifestations of PA according to different times of diagnosis.
METHODS
In total, 85 patients diagnosed with PA from January 1986 through March 2012 were reviewed retrospectively, based on their medical records. During two periods-1986 to 2005 and 2006 to 2012-41 and 44 patients, respectively, were diagnosed with PA. We compared the clinical and biological characteristics of PA between these periods.
RESULTS
The results demonstrate an increasing trend in the prevalence of idiopathic hyperaldosteronism (IHA; p = 0.19). In the 2006 to 2012 period, patients with PA presented with higher serum potassium levels at the time of diagnosis than in the 1986 to 2005 period (p < 0.0002). Adrenal vein sampling (AVS) was performed mostly in the latter period (82.3%) and the diagnostic accuracy of adrenal computed tomography, compared with AVS, was only 56.2%. About 78.0% versus 86.3% of patients had at least one target organ damage (TOD) in the 1986 to 2005 and 2006 to 2012 periods, respectively (p = 0.39). However, patients with TOD were older and had longer durations of hypertension than patients without, in both periods.
CONCLUSIONS
PA is becoming more prevalent. There was an increasing tendency for IHA, and more PA patients presented with normokalemia than in the earlier period. Early and accurate diagnosis of PA with AVS and proper treatment should have substantial prognostic value.

Keyword

Hyperaldosteronism; Hypertension; Hypokalemia

MeSH Terms

Adrenal Cortex Neoplasms/diagnosis/epidemiology
Adrenal Glands/radiography
Adrenocortical Adenoma/diagnosis/epidemiology
Adult
Biological Markers/blood
Female
Humans
Hyperaldosteronism/blood/*diagnosis/epidemiology/therapy
Hyperkalemia/diagnosis/epidemiology
Hyperplasia
Hypertension/diagnosis/epidemiology
Male
Middle Aged
Potassium/blood
Predictive Value of Tests
Prevalence
Republic of Korea/epidemiology
Retrospective Studies
Risk Factors
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Biological Markers
Potassium