Primary Aldosteronism in Patients in China With Recently Detected Hypertension

Xu, Zhixin; Yang, Jun; Hu, Jinbo; Song, Ying; He, Wenwen; Luo, Ting; Cheng, Qingfeng; Ma, Linqiang; Luo, Rong; Fuller, Peter J.; Cai, Jun; Li, Qifu; Yang, Sen; Mei, Mei; Luo, Suxin; Liao, Kangla; Zhang, Yao; He, Yong; He, Yihong; Xiao, Ming; Peng, Bin

doi:10.1016/j.jacc.2020.02.052

Cited by 139 publications

(131 citation statements)

References 29 publications

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“…Their first experiences with care were found to be associated with regular healthcare service utilization as well as regular medication intake. In line with earlier evidence, this finding suggests that seeking care from health facilities at an early stage promotes better control of hypertension and diabetes [46]. In fact, some studies further point out that not only whether PWHD received care from health providers but also how previous care was given influences the self-management of PWHD [16].…”

Section: Discussionsupporting

confidence: 83%

Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China

Gao

Peng

Wang

et al. 2020

IJERPH

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Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PWHD), and its association with the first experience with care and individual factors in rural Southwestern China. This cross-sectional study was carried out in Yunnan province in 2018 and recruited 292 PWHD and 122 village clinics from 122 villages in 10 counties. Participants were interviewed using a structured questionnaire. Results show around 39% of hypertensive and 25% of diabetic patients neither visited physicians nor took medicine regularly during the preceding three months of the interview date. The regression results further indicated that individual characteristics of the PWHD, including patient age, health status, and economic level, as well as their first experience with care, were significantly associated with their regular healthcare behavior. In addition to providing medical services, on average each sample village clinic, with around two physicians, simultaneously managed 180 hypertensive and 45 diabetic patients. This study revealed the need for further reforms in terms of improving self-management and thus recommends an increase in the quantity and the quality of human resources in the primary healthcare realm in rural China.

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Section: Discussionsupporting

confidence: 83%

Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China

Gao

Peng

Wang

et al. 2020

IJERPH

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“…Approximately 44.7% of Chinese adults aged 35-75 years have hypertension, and it was estimated that 244.5 million Chinese adults experienced hypertension [1,2]. Primary aldosteronism (PA) is the most common cause of secondary hypertension with a prevalence of at least 4% in patients with newly diagnosed hypertension in Chinese population [3]. PA is associated with increased risk of cardiovascular disease compared with patients with primary hypertension [4].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and effectiveness of a single-catheter approach for adrenal vein sampling in patients with primary aldosteronism

et al. 2021

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Background Adrenal vein sampling (AVS) is the preferred method for subtyping patients with primary aldosteronism, while the procedure is technically challenging. This study evaluated the feasibility and effectiveness of a single-catheter approach for AVS. Methods A retrospective analysis of 106 consecutive patients who underwent AVS was performed to determine the procedural success and complication rates. Bilateral AVS procedures were performed using a single 5-Fr Tiger catheter with repeated manual reshaping. Results We successfully advanced the catheter into the bilateral adrenal veins of all patients and reached a 90.6% procedural success rate of AVS. The procedural period was 33.0 ± 8.2 min, the fluoroscopy period was 5.8 ± 1.7 min, and the diagnostic contrast used was 17.3 ± 5.5 ml. Only one patient (0.9%) had a hematoma at the femoral puncture site. No other complications were observed. The operation period gradually shortened as the cumulative number of operations increased. The number of procedures required to overcome the learning curve was about 33 cases. Conclusions The single-catheter approach is feasible and effective for AVS. Moreover, this approach required a relatively short learning curve for an inexperienced trainee.

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“…Data were retrospectively extracted from 2 large PA databases established by the Endocrine Hypertension Group at Hudson Institute of Medical Research / Monash Health in Australia and the CONPASS (Chongqing PA Study) at The First Affiliated Hospital of Chongqing Medical University in China [ 22 , 23 ]. Relevant information for the current study were extracted for the periods of 2013 to April 2020 (China) and 2016 to April 2020 (Australia).…”

Section: Methodsmentioning

confidence: 99%

“…Two liters of saline was infused over 4 hours and the diagnosis of PA was confirmed at the Australian center if the plasma aldosterone concentration remained >140 pmol/L after a recumbent SST, or >170 pmol/L after a seated SST [ 23 ]. The cutoff used by the Chinese center was plasma aldosterone >210 pmol/L (>8 ng/dL) after a recumbent SST, or >235 pmol/L (>8.5 ng/dL) after a seated SST [ 22 ]. Patients who did not meet the criteria for PA served as hypertensive control subjects.…”

Section: Methodsmentioning

confidence: 99%

A multi-centre study of neutrophil-to-lymphocyte ratio in primary aldosteronism

Libianto

Chee

et al. 2020

Journal of the Endocrine Society

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Background Hypertensive patients with primary aldosteronism (PA) have a higher risk of cardiovascular complications than those with blood pressure-matched essential hypertension. The excess cardiovascular consequences of PA can be attributed to the pro-inflammatory effect of excessive aldosterone and mineralocorticoid receptor activation in a range of peripheral tissues and cell types. The neutrophil-to-lymphocyte ratio (NLR) is a widely available markers of inflammation which has been shown to predict cardiovascular outcome in the general population. This study aims to evaluate the use of NLR as a potential biomarker of PA and PA severity. Methods Patients with PA (n=355) were identified from two large PA databases in Australia and China, while controls (n=222) were patients with hypertension who were referred for assessment but did not meet the diagnostic criteria for PA. The NLR was retrospectively collected from routine full blood examination, prior to commencement of targeted treatment for PA. Results The NLR did not differ between PA patients and hypertensive controls (median 2.3 and 2.4, p=0.563). However, amongst patients with PA, the NLR was positively correlated with baseline and post-saline aldosterone levels (r=0.22 and p<0.001 for both) and negatively correlated with serum potassium (r=-0.15, p=0.006). Furthermore, in a logistic regression analysis of data from patients with PA, the NLR predicted the presence of co-morbid CKD (defined as eGFR < 60mL/min/1.73m 2) with an odds ratio of 1.5 (p=0.003). Conclusion Whilst the NLR did not distinguish PA from controls, it was a marker of PA severity, being associated with aldosterone concentration as well as the presence of CKD. A prospective study is needed to further clarify the role of NLR in predicting end-organ damage associated with PA.

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Primary Aldosteronism in Patients in China With Recently Detected Hypertension

Cited by 139 publications

References 29 publications

Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China

Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China

Feasibility and effectiveness of a single-catheter approach for adrenal vein sampling in patients with primary aldosteronism

A multi-centre study of neutrophil-to-lymphocyte ratio in primary aldosteronism

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