Comparison of Target Organ Damages between Primary Aldosteronism and Essential Hypertension

Juri Park; Dong Jin Kim; Sae Jeong Yang; Sook Hae Kim; Soo Yeon Park; Hye Jin Yoo; Yun Jeong Lee; Hee Young Kim; Ohk Hyun Ryu; Kye Won Lee; Ji A Seo; Sin Gon Kim; Kyung Mook Choi; Sei Hyun Baik; Dong Seop Choi

doi:10.3803/jkes.2007.22.1.11

Journal List > J Korean Endocr Soc > v.22(1) > 1003349

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Park, Kim, Yang, Kim, Park, Yoo, Lee, Kim, Ryu, Lee, Seo, Kim, Choi, Baik, and Choi: Comparison of Target Organ Damages between Primary Aldosteronism and Essential Hypertension

Original Article

Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2007; 22(1): 11-18.

Published online: 20 February 2007

DOI: https://doi.org/10.3803/jkes.2007.22.1.11

Comparison of Target Organ Damages between Primary Aldosteronism and Essential Hypertension

Juri Park, Dong Jin Kim, Sae Jeong Yang, Sook Hae Kim, Soo Yeon Park, Hye Jin Yoo, Yun Jeong Lee, Hee Young Kim, Ohk Hyun Ryu, Kye Won Lee, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi

Department of Internal Medicine, Korea University College of Medicine, Korea.

Received 11 September 2006 Accepted 23 October 2006

Abstract

Background

A number of recent clinical studies have reported marked target organ damages in patients with primary aldosteronism. The aim of this study was to compare the incidence of target organ damages in patients with primary aldosteronism (PA) and essential hypertension (EHT).

Methods

The clinical records of 41 PA patients, over a 20-year period, were retrospectively analyzed. The clinical characteristics and incidence of target organ damages of 33 of the patients in this group were compared with those of 66 patients with essential hypertension, directly matched for age, gender and mean blood pressure. 8 of the PA patients could not be matched with EHT patients for age, gender and mean blood pressure, so were excluded from the comparison. The patients with essential hypertension were sampled from patients who visited for the evaluation of hypertension.

Results

Ischemic heart diseases were found in 18.2 and 10.6% of patients with PA and EHT, respectively (P = 0.22). From echocardiograms, left ventricular hypertrophy was found in 93.3% and 61.4% of patients with PA and EHT, respectively (P = 0.017). The degrees of left ventricular hypertrophy were correlated with the levels of serum aldosterone, with an r value of 0.490 (P < 0.005). Cerebrovascular attack was found in 18.2% and 1.5% of patients with PA and EHT, respectively (P = 0.005). Hypertensive retinopathy was found in 50% and 33.3% of patients with PA and EHT (P = 0.255), and nephropathy was found in 42.4% and 25.8% of patients with PA and EHT, respectively (P = 0.074).

Conclusion

Patients with primary aldosteronism had target organ damages more frequently than with those with essential hypertension, which was independent of blood pressure.

Keywords: Aldosteronism, Hypertension, Left ventricular hypertrophy

Figures and Tables

Table 1

Subtypes of primary aldosteronism in 41 patients

Table 2

Clinical characteristics of 41 patients with primary aldosteronism

BMI; body mass index.

Values expressed as mean ± SD.

Table 3

Biological characteristics of 41 patients with primary aldosteronism

Values expressed as mean ± SD.

Table 4

Frequency of target organ damages in 41 patients with primary aldosteronism

LVH; left ventricular hypertrophy.

Table 5

Comparison of clinical and biochemical characteristics in patients with PA and EHT

BMI; body mass index.

Values expressed as mean ± SD.

Table 6

Comparison of target organ damages rates in patients with PA and EHT

CVA; cerebrovascularattack, IHD; ischemic heart disease, LVH; left ventricular hypertrophy, ECG; electrocardiogram, Echo; echocardiogram.

^*Fisher's exact test.

Table 7

Correlation between LVMI and Levels of Aldosterone in 20 Patients with PA

LVM; left ventricular mass, LVMI; left ventricular mass index.

^*Spearman partial correlation (control values = age, blood pressure, hypertension duration).

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