Similar prevalence of hyperaldosteronism in African American and White subjects with resistant hypertension

Husain, S., Gaddam, K., Pimenta, E. and Calhoun, D. A. (2008). Similar prevalence of hyperaldosteronism in African American and White subjects with resistant hypertension. In: Journal of Investigative Medicine. Proceedings of: AFMR Southern Regional Meeting Abstracts. Southern Regional Meeting of the American Federation for Medical Research, New Orleans, LA, USA, (345-345). 12-14 February 2008. doi:10.1097/01.JIM.0000308093.71382.c0


Author Husain, S.
Gaddam, K.
Pimenta, E.
Calhoun, D. A.
Title of paper Similar prevalence of hyperaldosteronism in African American and White subjects with resistant hypertension
Conference name Southern Regional Meeting of the American Federation for Medical Research
Conference location New Orleans, LA, USA
Conference dates 12-14 February 2008
Proceedings title Journal of Investigative Medicine. Proceedings of: AFMR Southern Regional Meeting Abstracts   Check publisher's open access policy
Journal name Journal of Investigative Medicine   Check publisher's open access policy
Place of Publication Hagerstown, MD., U.S.A.
Publisher Lippincott Williams & Wilkins
Publication Year 2008
Sub-type Oral presentation
DOI 10.1097/01.JIM.0000308093.71382.c0
ISSN 1081-5589
Volume 56
Issue 1
Start page 345
End page 345
Total pages 1
Language eng
Formatted Abstract/Summary
Purpose of Study:
To test for racial differences in the prevalence of hyperaldosteronism in subjects with resistant hypertension.

Methods Used:
Consecutive subjects referred to the University of Alabama at Birmingham (UAB) hypertension clinic for resistant hypertension (uncontrolled blood pressure on 3 antihypertensive agents) were prospectively evaluated with a plasma aldosterone concentration (PAC), plasma renin activity (PRA), a 24-hr urine collection for aldosterone, cortisol, sodium and potassium during a normal diet. All subjects were on a stable antihypertensive regimen without use of potassium sparing diuretics.

Summary of Results:

A total of 359 patients with resistant hypertension were evaluated, including 174 male and 185 females. There were 190 white and 169 black subjects. Blacks were younger than whites (Age: 51.76±10.90 vs. 57.2±10.96 years, p<0.001), had a higher BMI (34.04±7.38 vs. 31.74± 5.91 kg/m, P=0.005), higher clinic BP (147±22/88±17 vs. 141±21/81±14 mm Hg p<0.001). Number of antihypertensive medications (4.08±1.25 vs. 4.13±1.08) and urinary aldosterone excretion (12.28±10.36 vs. 12.86±10.73 µg/24-hr) were similar for blacks and whites. Whites had a higher serum potassium (3.99±0.46 vs. 3.83±0.43 mEq/L, p<0.001), PAC (13.75±9.75 vs. 11.93±10.85 ng/dL, p=0.015), urinary cortisol (106.68±60.89 vs. 90.47±53.21 µg/24-hr, p=0.019), urinary sodium (195.88±82.78 vs. 171.12±91.08 mEq/24-hr, p=0.001), urinary potassium (73.00±32.53 vs. 51.89±24.83 mEq/24-hr, p<0.001), and BNP (51.63±81.59 vs. 41.69±76.22 pg/ml, p=0.023) than blacks. The prevalence of hyperaldosteronism on the basis of ARR >=20 (29.6% vs. 31.1%) or using PRA<1.0 and urinary aldosterone >=12µg/24- hr (23.7% Vs 22.6 %) was not different by race.

Conclusions:
These data demonstrate that there is no racial difference in the prevalence of hyperaldosteronism in subjects with resistant hypertension. These findings support equal vigor in screening African American and white patients with resistant hypertension for primary aldosteronism.

Subjects 1103 Clinical Sciences
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Unknown

 
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Created: Thu, 04 Mar 2010, 09:30:07 EST by Laura McTaggart on behalf of Mater Clinical School