Endocrine Abstracts

Introduction: Primary hyperaldosteronism (PH) is a cause of arterial hypertension (HT). The prevalence ranged from 1 to 15%. PH is associated with higher rates of cardiovascular morbidity and mortality. PH is under-diagnosed. The aims were to know the prevalence of PH, the clinical and hormonal profiles, outcomes, and prognosis of our population.

Material and Methods: A retrospective review of patients with primary hyperaldosteronism in our hospital in the last 20 years (1996–2016). We analyzed motive for the screening, HT, CV risk factors and events at the time of diagnosis, aldosterone levels (ALD), plasma renin activity (ARP), RATIO ALD/PRA, and treatment outcomes.

Results: Forty-six patients, 26 men, and 20 women. Age of 52 years (29–81). In 80%, the onset was hypertension with hypokalemia, 17% was severe or resistant HTA, and 3% was hypertension with an adrenal mass. The diagnostic delay was 12 years (0–43). At presentation, 60% HVI, CVD 35%, PAD 22%. DM2 in 13%, obesity in 41%, dyslipidemia 45%. Serum ALD were 49 ng/dl (10.7–134.2 ng/ml), 6% below 15 ng/dl. Mean ARP ng/ml per h was 0.33 (<0.02–1.48). CT or/and MRI were performed at 100%. Adrenal Catheterization in 4 patients. In contrast, functional scintigraphy of the adrenal gland was performed in 35% of patients. Unilateral adenoma in 56.5% and removed surgically. Bilateral adenoma in 4%, and bilateral hyperplasia in 39.5%, both were in medical treatment.

Conclusions: The number of cases is lower than expected. The delay in diagnosis increases vascular morbidity. Our data suggest a level ALD of ≥ 10 ng /dl suspect a PA, lower than that recommended in the guidelines, in line with data from other recent studies. Adrenal catheterization is not a common practice in our environment as a pre-surgery test, instead we perform functional scintigraphy of the adrenal gland. The distribution of the etiological diagnosis is similar to other series.