Endocrine Abstracts

Background: Primary aldosteronism is associated with increased vascular mortality and morbidity.

Aims: We aimed to assess metabolic and hormonal profile differences in patients with primary aldosteronism (PA) compared with patients with essential hypertension (EH).

Patients and methods: Thirty-one patients (11 M/20 F) with primary aldosteronism, aged 46.2±12.9 years and 64 patients (24 M/40 F) with essential hypertension, aged 40.9±13 years, were retrospectively reviewed. Plasma aldosterone and plasma direct renin were measured by chemiluminescence (CLIA).

Results: Systolic blood pressure was significantly higher in PA patients (214.1±27.5 mmHg) than in patients with EH (197.8±29 mmHg), P=0.02, while diastolic blood pressure was similar. Body mass index tended to be higher in patients with EH (29.9±6.4 kg/m²) than in PA patients (27.8±1.1 kg/m²), P=0.07. Serum fasting glucose, total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides were similar between the two groups. PA patients had higher median midnight serum cortisol (4.3 μg/dl vs 1.83 μg/dl, P=0.057), significantly higher median 0800 hrs. serum plasma cortisol after 1 mg dexamethasone suppression test (1.34 μg/dL vs 0.8 μg/dL, P=0.01) and plasma metanephrines (50.4 pg/ml vs 29.4 pg/ml, P=0.048) than patients with EH. Serum PTH levels were significantly higher in patients with PA (76.6±23.7 pg/ml) than in patients with EH (46.7±17.9 pg/ml), P=0.02, while 25 OH vitamin D levels were similar.

Conclusion: PA patients showed a more severe systolic hypertension, with similar metabolic profile and an adverse hormonal profile with a slight cortisol and PTH excess.