M012: Positive screening for primary aldosteronism in blacks and whites with essential hypertension

• Published in: American journal of hypertension 2000-04, Vol.13 (S2), p.303A-303A
• Main Authors: Schwartz, G.L., Chapman, A.B., Young, W.F., Boerwinkle, E., Turner, S.T.
• Format: Article
• Language: English
• Subjects: Aldosterone; screening; secondary hypertension
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/S0895-7061(00)01089-X

We determined the plasma aldosterone concentration (PAC)-to-renin activity (PRA) ratio (ARR) after a 4-week drug free interval in a population-based sample of 329 adults with presumed essential hypertension [107 black women (BW), 42 black men (BM), 72 white women (WW) and 108 white men (WM)]. Blood was obtained in the morning with subjects in the sitting position after a period of ambulation. A positive screening test was defined as an ARR of ≥30 with a PAC ≥20 ng/dL. The overall prevalence of a positive screening test was 14.6%. The prevalence of a positive screening test was higher in BW than in BM (26.2% vs. 11.9%, P = 0.059) and also higher in BW than in WW (26.2% vs. 6.9%, P = 0.001). There were no differences in the prevalences of a positive screening test between WW and WM or between BM and WM. In each race-gender group, PRA was significantly lower, and PAC was significantly higher in the screen positive than in the screen negative subjects (P ≤ 0.05). Systolic blood pressure was higher in screen positive than in screen negative BM, BW, and WM. Within each race-gender group, no differences between screen positive and screen negative subjects were noted in diastolic blood pressure, age, body mass index, or blood sodium, potassium, fasting blood glucose, cholesterol, and triglyceride concentrations. These results indicate a high prevalence of a positive screening test for primary aldosteronism in a population-based sample of adults with presumed essential hypertension, especially among BW.