Comparison of ambulatory blood pressure between patients with primary aldosteronism and other forms of hypertension
© 2020 John Wiley & Sons Ltd..
OBJECTIVE: Primary aldosteronism (PA) is a potentially curable cause of hypertension associated with worse cardiovascular prognosis than blood pressure-matched essential hypertension (EH). Effective targeted treatment for PA is available with the greatest benefit seen if treatment is started early, prior to the development of end-organ damage. However, PA is currently substantially under-diagnosed. The standard screening test for PA, the aldosterone-to-renin ratio (ARR), is performed infrequently in both primary and tertiary care. In contrast, ambulatory blood pressure monitoring (ABPM) is frequently utilized in the assessment of hypertension. The aim of this study was to compare ABPM parameters in hypertensive patients with and without PA, in order to identify features of ABPM associated with PA that can prompt screening.
STUDY DESIGN: Patients with PA (n = 55) were identified from a tertiary clinic specializing in the management of endocrine causes of hypertension whilst the controls (n = 389) were consecutive patients with hypertension but without a known diagnosis of PA who were referred for ABPM.
RESULTS: In this study, PA patients were younger and had higher 24-h, day, and night-time blood pressure compared with controls despite similar number of antihypertensive medications. However, there was no significant difference in nocturnal dipping or day-night blood pressure variability between the two groups.
CONCLUSIONS: An elevated ambulatory blood pressure in patients on multiple antihypertensives could suggest underlying PA but in the absence of other distinguishing features, ABPM could not reliably differentiate PA from other forms of hypertension. Routine biochemical screening for PA remained the most reliable way of detecting this treatable secondary cause of hypertension.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:94 |
|---|---|
| Enthalten in: |
Clinical endocrinology - 94(2021), 3 vom: 01. März, Seite 353-360 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Libianto, Renata [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Ambulatory blood pressure |
|---|
| Anmerkungen: |
Date Completed 29.07.2021 Date Revised 29.07.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/cen.14373 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM318370867 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM318370867 | ||
| 003 | DE-627 | ||
| 005 | 20231225165220.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/cen.14373 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1061.xml |
| 035 | |a (DE-627)NLM318370867 | ||
| 035 | |a (NLM)33270939 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Libianto, Renata |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of ambulatory blood pressure between patients with primary aldosteronism and other forms of hypertension |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.07.2021 | ||
| 500 | |a Date Revised 29.07.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 John Wiley & Sons Ltd. | ||
| 520 | |a OBJECTIVE: Primary aldosteronism (PA) is a potentially curable cause of hypertension associated with worse cardiovascular prognosis than blood pressure-matched essential hypertension (EH). Effective targeted treatment for PA is available with the greatest benefit seen if treatment is started early, prior to the development of end-organ damage. However, PA is currently substantially under-diagnosed. The standard screening test for PA, the aldosterone-to-renin ratio (ARR), is performed infrequently in both primary and tertiary care. In contrast, ambulatory blood pressure monitoring (ABPM) is frequently utilized in the assessment of hypertension. The aim of this study was to compare ABPM parameters in hypertensive patients with and without PA, in order to identify features of ABPM associated with PA that can prompt screening | ||
| 520 | |a STUDY DESIGN: Patients with PA (n = 55) were identified from a tertiary clinic specializing in the management of endocrine causes of hypertension whilst the controls (n = 389) were consecutive patients with hypertension but without a known diagnosis of PA who were referred for ABPM | ||
| 520 | |a RESULTS: In this study, PA patients were younger and had higher 24-h, day, and night-time blood pressure compared with controls despite similar number of antihypertensive medications. However, there was no significant difference in nocturnal dipping or day-night blood pressure variability between the two groups | ||
| 520 | |a CONCLUSIONS: An elevated ambulatory blood pressure in patients on multiple antihypertensives could suggest underlying PA but in the absence of other distinguishing features, ABPM could not reliably differentiate PA from other forms of hypertension. Routine biochemical screening for PA remained the most reliable way of detecting this treatable secondary cause of hypertension | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a ambulatory blood pressure | |
| 650 | 4 | |a blood pressure variability | |
| 650 | 4 | |a hypertension | |
| 650 | 4 | |a nocturnal dipping | |
| 650 | 4 | |a primary aldosteronism | |
| 650 | 7 | |a Antihypertensive Agents |2 NLM | |
| 700 | 1 | |a Menezes, Serena |e verfasserin |4 aut | |
| 700 | 1 | |a Kaur, Amrina |e verfasserin |4 aut | |
| 700 | 1 | |a Gwini, Stella May |e verfasserin |4 aut | |
| 700 | 1 | |a Shen, Jimmy |e verfasserin |4 aut | |
| 700 | 1 | |a Narayan, Om |e verfasserin |4 aut | |
| 700 | 1 | |a Fuller, Peter J |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Young, Morag J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical endocrinology |d 1972 |g 94(2021), 3 vom: 01. März, Seite 353-360 |w (DE-627)NLM000089117 |x 1365-2265 |7 nnns |
| 773 | 1 | 8 | |g volume:94 |g year:2021 |g number:3 |g day:01 |g month:03 |g pages:353-360 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/cen.14373 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 94 |j 2021 |e 3 |b 01 |c 03 |h 353-360 | ||