P-669: Screening for primary aldosterone in older patients with hypertension

• Published in: American journal of hypertension Vol. 14; no. S1; p. 253A
• Main Authors: Wofford, M. R., Harkins, K. G., King, D. S., Wyatt, S. B., Jones, D. W.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2001
• Subjects: Elderly; Primary Aldosterone; Screening
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/S0895-7061(01)01999-9

The prevalence of primary aldosterone (PA) among hypertensive patients in referral centers is estimated to be 12%. The prevalence of PA among older subjects in referral populations has not been reported. Screening for PA with the plasma aldosterone concentration (PAC; in ng/ml) to plasma renin activity (PRA; in ng/ml/hr) has led to a dramatic increase in detection and treatment of the disorder. A positive screen for PA in our center is a PAC/PRA > 30. Using an electronic data base we searched medical records for subjects ≥ 60 years old who had a positive PAC/PRA. Subjects were screened if they had resistant hypertension or hypokalemia. Blood pressure measures taken prior to and following initiation of a treatment regimen including a potassium-sparing diuretic are reported. Forty patients with a mean age of 65 had a positive screen for PA. Fifty-five percent were white; 75% female. (See Table) MEAN MEAN Potassium 4.0 Pre SBP/DBP 167/91 Creatinine 1.9 *MAP 115 Aldosterone 35 Post SBP/DBP 143/85 Renin 0.2 MAP 99 PAC/PRA 64.8 *Mean arterial pressure PA may be detected in older patients with poorly controlled hypertension. Detection of PA using the PAC/PRA may lead to more effective control in this high-risk population. PA should be considered in the evaluation of resistant hypertension in elderly patients.