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Article: Primary hyperaldosteronism among Chinese hypertensive patients: how are we doing in a local district in Hong Kong

TitlePrimary hyperaldosteronism among Chinese hypertensive patients: how are we doing in a local district in Hong Kong
Authors
KeywordsAldosterone
Adrenal cortex adenoma
Adrenal hyperplasia
Adrenalectomy
Aged
Issue Date2012
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hk
Citation
Hong Kong Medical Journal, 2012, v. 18 n. 3, p. 193-200 How to Cite?
AbstractOBJECTIVES: To estimate the point prevalence of primary hyperaldosteronism in a government out-patient setting and to compare associated patient characteristics with those having essential hypertension. DESIGN: Case series with external comparison. SETTING: A single public hospital (Caritas Medical Centre) and all five associated general out-patient clinics in Sham Shui Po district in Hong Kong. PATIENTS: All patients with confirmed primary hyperaldosteronism and randomly selected patients with essential hypertension from a medical specialist clinic and general out-patient clinics, retrieved from a computer database for the period January 2007 to December 2008. MAIN OUTCOME MEASURES: Estimated point prevalence of primary hyperaldosteronism among hypertensive patients treated in the public sector of Sham Shui Po district. Patient age when hypertension was diagnosed, number of antihypertensive drugs used for treatment, and the presence of target organ damage in the patients with primary hyperaldosteronism and those with essential hypertension were compared. RESULTS: Among the 46 012 patients receiving antihypertensive treatment, 49 were confirmed to have primary hyperaldosteronism. The estimated point prevalence of primary hyperaldosteronism among these hypertensive patients was 0.106% only, which was far smaller than figures from other countries. When compared with the 147 patients with essential hypertension by multivariate analysis, those with primary hyperaldosteronism were: (1) associated with longer durations of hypertension (odds ratio=1.14; 95% confidence interval, 1.06-1.24) despite being younger at the time of study, (2) likely to be taking three or more antihypertensive drugs (odds ratio=2.51; 95% confidence interval, 1.59-3.95), and (3) more likely to have left ventricular hypertrophy (odds ratio=5.01; 95% confidence interval, 1.83-13.69). All primary hyperaldosteronism patients studied presented with hypokalaemia. The need for antihypertensive drugs was markedly reduced after adrenalectomy for adrenal adenoma. CONCLUSIONS: Primary hyperaldosteronism, which is potentially a surgically curable cause of hypertension, appeared to be underdiagnosed in our locality. Screening by aldosterone-renin ratio of high-risk individuals may help improve patient outcomes.
Persistent Identifierhttp://hdl.handle.net/10722/159607
ISSN
2015 Impact Factor: 0.887
2015 SCImago Journal Rankings: 0.279
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorSy, WMen_US
dc.contributor.authorFu, SNen_US
dc.contributor.authorLuk, Wen_US
dc.contributor.authorWong, CKHen_US
dc.contributor.authorFung, LMen_US
dc.date.accessioned2012-08-16T05:53:09Z-
dc.date.available2012-08-16T05:53:09Z-
dc.date.issued2012en_US
dc.identifier.citationHong Kong Medical Journal, 2012, v. 18 n. 3, p. 193-200en_US
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/159607-
dc.description.abstractOBJECTIVES: To estimate the point prevalence of primary hyperaldosteronism in a government out-patient setting and to compare associated patient characteristics with those having essential hypertension. DESIGN: Case series with external comparison. SETTING: A single public hospital (Caritas Medical Centre) and all five associated general out-patient clinics in Sham Shui Po district in Hong Kong. PATIENTS: All patients with confirmed primary hyperaldosteronism and randomly selected patients with essential hypertension from a medical specialist clinic and general out-patient clinics, retrieved from a computer database for the period January 2007 to December 2008. MAIN OUTCOME MEASURES: Estimated point prevalence of primary hyperaldosteronism among hypertensive patients treated in the public sector of Sham Shui Po district. Patient age when hypertension was diagnosed, number of antihypertensive drugs used for treatment, and the presence of target organ damage in the patients with primary hyperaldosteronism and those with essential hypertension were compared. RESULTS: Among the 46 012 patients receiving antihypertensive treatment, 49 were confirmed to have primary hyperaldosteronism. The estimated point prevalence of primary hyperaldosteronism among these hypertensive patients was 0.106% only, which was far smaller than figures from other countries. When compared with the 147 patients with essential hypertension by multivariate analysis, those with primary hyperaldosteronism were: (1) associated with longer durations of hypertension (odds ratio=1.14; 95% confidence interval, 1.06-1.24) despite being younger at the time of study, (2) likely to be taking three or more antihypertensive drugs (odds ratio=2.51; 95% confidence interval, 1.59-3.95), and (3) more likely to have left ventricular hypertrophy (odds ratio=5.01; 95% confidence interval, 1.83-13.69). All primary hyperaldosteronism patients studied presented with hypokalaemia. The need for antihypertensive drugs was markedly reduced after adrenalectomy for adrenal adenoma. CONCLUSIONS: Primary hyperaldosteronism, which is potentially a surgically curable cause of hypertension, appeared to be underdiagnosed in our locality. Screening by aldosterone-renin ratio of high-risk individuals may help improve patient outcomes.-
dc.languageengen_US
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hk-
dc.relation.ispartofHong Kong Medical Journalen_US
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectAldosterone-
dc.subjectAdrenal cortex adenoma-
dc.subjectAdrenal hyperplasia-
dc.subjectAdrenalectomy-
dc.subjectAged-
dc.titlePrimary hyperaldosteronism among Chinese hypertensive patients: how are we doing in a local district in Hong Kongen_US
dc.typeArticleen_US
dc.identifier.emailSy, WM: winniesy@graduate.hku.hk-
dc.description.naturepublished_or_final_version-
dc.identifier.pmid22665682-
dc.identifier.scopuseid_2-s2.0-84862533364-
dc.identifier.hkuros205709en_US
dc.identifier.volume18en_US
dc.identifier.issue3-
dc.identifier.spage193en_US
dc.identifier.epage200en_US
dc.identifier.isiWOS:000304849200004-
dc.publisher.placeHong Kong-

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