The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension
Authors: Eugenia Gkaliagkousi, Panagiota Anyfanti, Antonios Lazaridis, Stella Douma
Journal: Annals of Internal Medicine (2018)

Letters15 May 2018The Spectrum of Subclinical Primary Aldosteronism and Incident HypertensionEugenia Gkaliagkousi, MD, PhD, Panagiota Anyfanti, MD, PhD, Antonios Lazaridis, MD, and Stella Douma, MD, PhDEugenia Gkaliagkousi, MD, PhDPapageorgiou Hospital, Thessaloniki, Greece (E.G., P.A., A.L., S.D.)Search for more papers by this author, Panagiota Anyfanti, MD, PhDPapageorgiou Hospital, Thessaloniki, Greece (E.G., P.A., A.L., S.D.)Search for more papers by this author, Antonios Lazaridis, MDPapageorgiou Hospital, Thessaloniki, Greece (E.G., P.A., A.L., S.D.)Search for more papers by this author, and Stella Douma, MD, PhDPapageorgiou Hospital, Thessaloniki, Greece (E.G., P.A., A.L., S.D.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We share Brown and colleagues' (1) interest in subclinical PA and applaud their important results. However, we believe that some points need to be stressed. Participants with a suppressed renin phenotype had a higher incidence of hypertension than those with an indeterminate and unsuppressed phenotype. This finding may have been anticipated, because these patients had elevated blood pressure and were more likely to be older, female, and African American (2, 3). Aldosterone levels were predictive of incident hypertension only in the context of suppressed renin. The authors describe the combination of suppressed renin with aldosterone levels exceeding ...References1. Brown JM, Robinson-Cohen C, Luque-Fernandez MA, Allison MA, Baudrand R, Ix JH, et al. The spectrum of subclinical primary aldosteronism and incident hypertension: a cohort study. Ann Intern Med. 2017;167:630-41. [PMID: 29052707]. doi:10.7326/M17-0882 LinkGoogle Scholar2. Rifkin DE, Khaki AR, Jenny NS, McClelland RL, Budoff M, Watson K, et al. Association of renin and aldosterone with ethnicity and blood pressure: the Multi-Ethnic Study of Atherosclerosis. Am J Hypertens. 2014;27:801-10. [PMID: 24436325] doi:10.1093/ajh/hpt276 CrossrefMedlineGoogle Scholar3. Fischer M, Baessler A, Schunkert H. Renin angiotensin system and gender differences in the cardiovascular system. Cardiovasc Res. 2002;53:672-7. [PMID: 11861038] CrossrefMedlineGoogle Scholar4. Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101:1889-916. [PMID: 26934393] doi:10.1210/jc.2015-4061 CrossrefMedlineGoogle Scholar5. Mulatero P, Verhovez A, Morello F, Veglio F. Diagnosis and treatment of low-renin hypertension. Clin Endocrinol (Oxf). 2007;67:324-34. [PMID: 17573898] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Papageorgiou Hospital, Thessaloniki, Greece (E.G., P.A., A.L., S.D.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L18-0026. 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 Jenifer M. Brown 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 Metrics 15 May 2018Volume 168, Issue 10Page: 755KeywordsAbsolute risk reductionAldosteroneBlood pressureConflicts of interestDisclosureExcretionHypertensionPhenotypesPrimary hypertension ePublished: 15 May 2018 Issue Published: 15 May 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...