The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension
Authors: Jenifer M. Brown, Anand Vaidya
Journal: Annals of Internal Medicine (2018)

Letters15 May 2018The Spectrum of Subclinical Primary Aldosteronism and Incident HypertensionJenifer M. Brown, MD and Anand Vaidya, MD, MMScJenifer M. Brown, MDBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.M.B., A.V.)Search for more papers by this author and Anand Vaidya, MD, MMScBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.M.B., A.V.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Spence notes that a low-renin phenotype may also suggest a phenotype of Liddle syndrome and wonders how this implication may have influenced our results in the context of racial differences. Data to address both of these issues are available in our study. The low-renin phenotype has been the focus of investigation for decades and may reflect a heterogeneous mixture of underlying mechanisms (1). The focus of our study was the potential for excessive mineralocorticoid receptor activation due to autonomous aldosterone secretion, characterized by suppressed renin and inappropriately high (albeit potentially normal) aldosterone levels; in the study, this ...References1. Baudrand R, Vaidya A. The low-renin hypertension phenotype: genetics and the role of the mineralocorticoid receptor. Int J Mol Sci. 2018;19. [PMID: 29439489] doi:10.3390/ijms19020546 CrossrefMedlineGoogle Scholar2. Markou A, Pappa T, Kaltsas G, Gouli A, Mitsakis K, Tsounas P, et al. Evidence of primary aldosteronism in a predominantly female cohort of normotensive individuals: a very high odds ratio for progression into arterial hypertension. J Clin Endocrinol Metab. 2013;98:1409-16. [PMID: 23471976] doi:10.1210/jc.2012-3353 CrossrefMedlineGoogle Scholar3. Baudrand R, Guarda FJ, Fardella C, Hundemer G, Brown J, Williams G, et al. Continuum of renin-independent aldosteronism in normotension. Hypertension. 2017;69:950-6. [PMID: 28289182] doi:10.1161/HYPERTENSIONAHA.116.08952 CrossrefMedlineGoogle Scholar4. Funder JW. Primary aldosteronism: the next five years. Horm Metab Res. 2017;49:977-83. [PMID: 29065433] doi:10.1055/s-0043-119802 CrossrefMedlineGoogle Scholar5. Vasan RS, Evans JC, Larson MG, Wilson PW, Meigs JB, Rifai N, et al. Serum aldosterone and the incidence of hypertension in nonhypertensive persons. N Engl J Med. 2004;351:33-41. [PMID: 15229305] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.M.B., A.V.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0882. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension Jenifer M. Brown , Cassianne Robinson-Cohen , Miguel Angel Luque-Fernandez , Matthew A. Allison , Rene Baudrand , Joachim H. Ix , Bryan Kestenbaum , Ian H. de Boer , and Anand Vaidya The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension J. David Spence The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension Kosuke Inoue and Tetsuo Nishikawa The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension Eugenia Gkaliagkousi , Panagiota Anyfanti , Antonios Lazaridis , and Stella Douma Metrics Cited bySpironolactone effect on the blood pressure of patients at risk of developing heart failure: an analysis from the HOMAGE trial 15 May 2018Volume 168, Issue 10Page: 755-756KeywordsAdrenocorticotropic hormoneAldosteroneDisclosureForecastingHypertensionMineralocorticoidsObservational studiesPhenotypesRisk managementSodium ePublished: 15 May 2018 Issue Published: 15 May 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...