ECE2024 Eposter Presentations Adrenal and Cardiovascular Endocrinology (155 abstracts)
Clinical features and complication profile of arterial hypertension in patients with primary aldosteronism
Siddiqa Soomauroo 1 , Faten Hadjkacem 1 , Abdelmuhaymen Missaoui 1 , Ahmad Ridwaan Auckburally 2 , Souhir Maalej 1 , Wiem Feki 2 , Zeinab Mnif 2 , Mouna Mnif 1 , Mohamed Abid 1 & Nabila Rekik 1
1Hedi Chaker University Hospital, Department of Endocrinology, Sfax, Tunisia; 2Hedi Chaker University Hospital, Department of Radiology, Sfax, Tunisia
Introduction: Primary aldosteronism (PA) is frequently recognized as the main cause of secondary hypertension. Its prevalence is on the rise, impacting a range of 1 to 30% among individuals with hypertension.
Patients and methods: Retrospective and descriptive study concerning 40 patients with PA, collected in the endocrinology department of the Hedi Chaker University Hospital of Sfax, over the period of 10 years from January 2010 to December 2022.
Results: The average age of our patients was 55.4 years. Among the 40 patients, 39 (16 men and 23 women) presented with hypertension. In 32% of cases, the hypertension was recent, evolving for less than 5 years. Severe hypertension was found in 11 cases and resistant hypertension in 4 others. Ten patients (25.6%) were on at least a triple anti-hypertensive therapy. The therapeutic classes most used were calcium channel blockers prescribed in 25 cases (64.1%), followed by ACE inhibitors in 12 cases (30.8%). The assessment of target organ damage revealed hypertensive retinopathy (n=4), hypertensive cardiopathy (n=8), microalbuminuria (n=26), proteinuria (n=3) and renal failure (n=8). In our study, we noted a statistically significant reduction of antihypertensive drugs in 36 patients who had received treatment, whether by surgery or spironolactone (P=0.001).
Conclusion: Sodium and water retention constitute the primary pathophysiological mechanism behind the elevation of blood pressure in PA. This hypervolemia, combined with other factors, accounts for the nearly constant presence of hypertension in patients with PA. This type of hypertension has no particular semiological features. Its severity is not perfectly correlated with the degree of hyperaldosteronism whereas the prevalence of PA is correlated to the degree of severity of hypertension. Some studies have reported a prevalence of PA that may exceed 20% in cases of resistant hypertension.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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