Prevalência do hiperaldosteronismo primário em uma liga de hipertensão arterial sistêmica

Ribeiro, Maria Jacqueline Silva; Neto, José Albuquerque de Figueiredo; Memória, Edson Viriato; Lopes, Maíra de Castro; Faria, Manuel dos Santos; Filho, Natalino Salgado; Oliveira, Thiara Castro de

doi:10.1590/s0066-782x2009000100007

Cited by 12 publications

(8 citation statements)

References 23 publications

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“…As already mentioned, several cross-sectional and prospective studies in unselected hypertensive populations have shown that the prevalence of PA is much higher than previously believed, although it varies significantly between studies ranging from 4.6 to 16.6% when confirmatory tests to diagnose PA were used (Table 2) (5,6,7,8,21,71,75,76,77,78,79,80,81,82). However, in patients with resistant hypertension, the prevalence of PA is reported to be even higher ranging from 17 to 23% (16,83).…”

Section: Prevalence Of Pa In Hypertension and Pre-hypertensionmentioning

confidence: 93%

PROGRESS IN ALDOSTERONISM: A review of the prevalence of primary aldosteronism in pre-hypertension and hypertension

Piaditis

Markou

Papanastasiou

et al. 2015

European Journal of Endocrinology

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Primary aldosteronism (PA) secondary to excessive and/or autonomous aldosterone secretion from the renin-angiotensin system accounts for w10% of cases of hypertension and is primarily caused by bilateral adrenal hyperplasia (BAH) or aldosterone-producing adenomas (APAs). Although the diagnosis has traditionally been supported by low serum potassium levels, normokalaemic and even normotensive forms of PA have been identified expanding further the clinical phenotype. Moreover, recent evidence has shown that serum aldosterone correlates with increased blood pressure (BP) in the general population and even moderately raised aldosterone levels are linked to increased cardiovascular morbidity and mortality. In addition, aldosterone antagonists are effective in BP control even in patients without evidence of dysregulated aldosterone secretion. These findings indicate a higher prevalence of aldosterone excess among hypertensive patients than previously considered that could be attributed to disease heterogeneity, aldosterone level fluctuations related to an ACTH effect or inadequate sensitivity of current diagnostic means to identify apparent aldosterone excess. In addition, functioning aberrant receptors expressed in the adrenal tissue have been found in a subset of PA cases that could also be related to its pathogenesis. Recently a number of specific genetic alterations, mainly involving ion homeostasis across the membrane of zona glomerulosa, have been detected in w50% of patients with APAs. Although specific genotype/phenotype correlations have not been clearly identified, differential expression of these genetic alterations could also account for the wide clinical phenotype, variations in disease prevalence and performance of diagnostic tests. In the present review, we critically analyse the current means used to diagnose PA along with the role that ACTH, aberrant receptor expression and genetic alterations may exert, and provide evidence for an increased prevalence of aldosterone dysregulation in patients with essential hypertension and pre-hypertension.

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Section: Prevalence Of Pa In Hypertension and Pre-hypertensionmentioning

confidence: 93%

PROGRESS IN ALDOSTERONISM: A review of the prevalence of primary aldosteronism in pre-hypertension and hypertension

Piaditis

Markou

Papanastasiou

et al. 2015

European Journal of Endocrinology

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“…Связь между избыточным потреблением поваренной соли и повышением артериально го давления была замечена задолго до откры тия методов измерения артериального дав ления и появления понятия «артериальная гипертензия». Сочетание наследственной пред расположенности к гипертонической болезни и Читайте нас на сайте: http://med expert.com.ua избыточному потреблению соли приводит к тому, что компенсаторные почечные механизмы со вре менем уже не могут полностью выводить избыток соли, что в свою очередь приводит к увеличению объема жидкости, вследствие чего увеличивается объем циркулирующей крови и повышается арте риальное давление [18,20]. В нашем исследовании большинство детей с АГ, страдавших избыточным весом и ожирением, питались несбалансировано.…”

Section: Discussionunclassified

“…Другое исследо вание [3] выявило положительную корреля цию между артериальным давлением, индек сом массы тела (ИМТ) и количеством потреб ляемой соли. Исследования последних лет доказали, что более восприимчивыми к разви тию АГ при повышеном потреблении натрия являются пациенты с ожирением, лица африканского происхождения, а также лица с отягощенным семейным анамнезом по АГ [4,13,18,20]. Синергическое дейстие вышепере численых факторов увеличивают риск разви тия АГ у детей.…”

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Contribution of behavioral risk factors in the implementation of arterial hypertension in children

Nelea¹,

Bichir-Thoreac²,

Svetlana³

2019

MPU

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Значительную роль в развитии первичной артериальной гипертензии (АГ) у детей играют поведенческие факторы риска, такие как неправильное питание, гиподинамия и ожирение. В последние годы развитию данной патологии нередко способствуют другие факторы, характерные для взрослого населения, из которых можно выделить хронический стресс, употребление алкоголя и табакокурение. Цель: определить влияние поведенческих факторов риска на развитие АГ у детей c различной массой тела. Материалы и методы. В исследование были включены 115 детей с АГ в возрасте 10-18 лет, разделенные на три группы в соответствии с индексом массы тела: I группа-35 детей с АГ и нормальным весом, II группа-36 детей с АГ и избыточной массой тела и III группа-44 ребенка с АГ и ожирением. С целью выявления образа жизни, культуры питания, хронического стресса, семейных вредных привычек был использован метод анкетирования. Результаты. Большинство детей с АГ, избыточной массой тела и ожирением ведут малоподвижный образ жизни и несбалансировано питаются, употребляя в избытке жирную пищу, легко усваиваемые углеводы и соль. Выводы. Пристальное внимание к категории детей с высоким риском развития АГ и ожирением, устранение поведенческих факторов риска, а также поддержание здорового образа жизни, правильного питания и занятий спортом будут способствовать качественной профилактике даной категории заболеваний. Исследование было выполнено в соответствии с принципами Хельсинкской Декларации. Протокол исследования был одобрен Локальным этическим комитетом (ЛЭК) учреждения. На проведение исследований было получено информированное согласие родителей детей (или их опекунов). Авторы заявляют об отсутствии конфликта интересов. Ключевые слова: поведенческие факторы риска, дети, артериальная гипертензия.

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“…The reported prevalence of PA in the general hypertensive population varies widely, ranging from 1% to 29.8%. [3][4][5][6] A systematic review data showed greatly variable prevalence and high heterogeneity between studies. 7 The heterogeneous results of these studies have been associated with geographic differences, patient selection, healthcare setting and variability in screening tests and diagnostic methods.…”

Section: Introductionmentioning

confidence: 99%

“…The most common cause of secondary hypertension is primary aldosteronism (PA). The reported prevalence of PA in the general hypertensive population varies widely, ranging from 1% to 29.8% 3–6. A systematic review data showed greatly variable prevalence and high heterogeneity between studies 7.…”

Section: Introductionmentioning

confidence: 99%

U-shaped relationship between left ventricular mass index and estimated glomerular filtration rate in patients with primary aldosteronism

Liao

Tsai

et al. 2020

Journal of Investigative Medicine

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Estimated glomerular filtration rate (eGFR) is an important topic in patients with primary aldosteronism (PA). However, the relationship between left ventricular structure and eGFR is unclear. We conducted a prospective, observational, and cross-sectional study to analyze 168 patients with PA and 168 propensity score-matched patients with essential hypertension (EH) as the control group, matched by age, gender, and systolic blood pressure. In the patients with PA, the eGFR was not correlated with left ventricular mass index (LVMI; r=−0.065, p=0.404), while in the patients with EH, the eGFR was negatively correlated with LVMI (r=−0.309, p<0.001). To test whether eGFR had a non-linear relationship with LVMI among the patients with PA, we stratified the patients with PA according to the tertile of eGFR (low, medium, and high tertile). The medium tertile of patients had a significantly lower LVMI than those in the other two tertiles (LVMI: 143.5±41.6, 120.5±40.5, and 133.1±34.3 g/m2, from the lowest to highest tertile of eGFR; analysis of covariance p=0.032). The medium tertile of eGFR is associated with lowest LVMI. Patients with PA with high and low eGFR were associated with higher LVMI. The findings implied that the reasons for an increased LVMI in patients with PA may be different to those in patients with EH.

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Prevalência do hiperaldosteronismo primário em uma liga de hipertensão arterial sistêmica

Abstract: The prevalence of primary hyperaldosteronism in the studied sample was 0.96% of the total. However, when only the patients with refractory hypertension were evaluated, the prevalence was 14.3%.

Cited by 12 publications

References 23 publications

PROGRESS IN ALDOSTERONISM: A review of the prevalence of primary aldosteronism in pre-hypertension and hypertension

PROGRESS IN ALDOSTERONISM: A review of the prevalence of primary aldosteronism in pre-hypertension and hypertension

Contribution of behavioral risk factors in the implementation of arterial hypertension in children

U-shaped relationship between left ventricular mass index and estimated glomerular filtration rate in patients with primary aldosteronism

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