Hyperaldosteronism is equally common in African-American and White patients with resistant hypertension

Husain, Saima, Nishizaka, Mari K., Pratt-Ubunama, Monique N., Gaddam, Krishna K., Pimenta, Eduardo, Oparil, Suzanne and Calhoun, David A. (2008). Hyperaldosteronism is equally common in African-American and White patients with resistant hypertension. In: 62nd Annual High Blood Pressure Conference 2008, Atlanta, GA, USA, (e42-e42). 17-20 September 2008. doi:10.1161/01.HYP.0000335249.42461.D0

Author Husain, Saima
Nishizaka, Mari K.
Pratt-Ubunama, Monique N.
Gaddam, Krishna K.
Pimenta, Eduardo
Oparil, Suzanne
Calhoun, David A.
Title of paper Hyperaldosteronism is equally common in African-American and White patients with resistant hypertension
Conference name 62nd Annual High Blood Pressure Conference 2008
Conference location Atlanta, GA, USA
Conference dates 17-20 September 2008
Journal name Hypertension   Check publisher's open access policy
Place of Publication Baltimore, MD
Publisher Lippincott Williams & Wilkins for the American Heart Association
Publication Year 2008
Sub-type Published abstract
DOI 10.1161/01.HYP.0000335249.42461.D0
ISSN 0194-911X
Volume 52
Issue 4
Start page e42
End page e42
Total pages 1
Language eng
Abstract/Summary Objective: Primary aldosteronism is a common cause of resistant hypertension with a prevalence of approximately 20%. Racial differences in the prevalence of hyperaldosteronism in patients with resistant hypertension have not been previously described. Methods: Consecutive subjects referred to the University of Alabama at Birmingham hypertension clinic for resistant hypertension were prospectively evaluated with a plasma aldosterone concentration (PAC), plasma renin activity (PRA), and a 24-hr urine collection for aldosterone, sodium, and potassium during the patient’s usual diet. All subjects were on a stable antihypertensive regimen without use of potassium sparing diuretics. Results: A total of 295 patients with resistant hypertension were evaluated, including 157 white and 138 black subjects. There were 86 black females and 64 white females. Clinic BP was higher in blacks compared to whites (148±20/89 ±16 vs. 143 ±20/83 ± 13, p 0.034) while receiving a similar number of prescribed medications. Diuretic use was the same, but whites were more likely on an ACE inhibitor and beta blocker than blacks. Whites had a higher plasma aldosterone (14.3 ± 9.5 vs. 11.0 ±8.0 ng/dl, p<0.001) and higher urinary potassium excretion (75.1± 34.4 vs. 52.2 ± 23.7 mEq/24-hr, p<0.001). Blacks had a lower PRA (1.9±3.3 vs. 2.8 ± 4.4 ng/ml/hr, p ns). Urinary aldosterone excretion tended to be higher in white compared to black subjects (13.7± 11.3 vs.11.9 ±7.6 mcg/24-hr, p=ns). In spite of higher aldosterone levels in white subjects, the prevalence of hyperaldosteronism based on a PRA<1.0 and urine aldo≥12 was not different in white (25.5%) vs. black subjects (26.1%). Hyperaldosteronism was more common in both black and white males compared to females (white males 38.7% vs. white females 6.3 %, p<0.001; black males 38.5% vs. black females 18.6%, p=0.018). Conclusion: These data demonstrate that hyperaldosteronism is equally common in African American and white patients with resistant hypertension. Males in both races have a higher prevalence of hyperaldosteronism than females. These findings support equal vigor in screening African American and white patients with resistant hypertension for primary aldosteronism.
Subjects 1103 Clinical Sciences
1102 Cardiovascular Medicine and Haematology
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Unknown
Additional Notes Abstract number: 039

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