The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension
Authors: J. David Spence
Journal: Annals of Internal Medicine (2018)

Letters15 May 2018The Spectrum of Subclinical Primary Aldosteronism and Incident HypertensionJ. David Spence, MDJ. David Spence, MDRobarts Research Institute, London, Ontario, Canada (J.D.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Brown and colleagues (1) report that 46% of study participants in MESA (Multi-Ethnic Study of Atherosclerosis) had markedly suppressed plasma renin activity, which was associated with a higher likelihood of subsequent hypertension. This finding was more common in black participants. The authors focused on primary aldosteronism (PA); neither their article nor the accompanying editorial mentioned Liddle syndrome or its variants. Primary aldosteronism, probably mainly due to bilateral adrenocortical hyperplasia, is certainly more common in black persons. In an African study of resistant hypertension, we found 14 nonsynonymous variants of aldosterone synthase (CYP11B2); 9 of 14 variants were ...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. Jones ES, Spence JD, Mcintyre AD, Nondi J, Gogo K, Akintunde A, et al. High frequency of variants of candidate genes in black Africans with low renin-resistant hypertension. Am J Hypertens. 2017;30:478-83. [PMID: 28052878] doi:10.1093/ajh/hpw167 CrossrefMedlineGoogle Scholar3. Jones ES, Owen EP, Rayner BL. The association of the R563Q genotype of the ENaC with phenotypic variation in Southern Africa. Am J Hypertens. 2012;25:1286-91. [PMID: 22895453] doi:10.1038/ajh.2012.125 CrossrefMedlineGoogle Scholar4. Tapolyai M, Uysal A, Dossabhoy NR, Zsom L, Szarvas T, Lengvárszky Z, et al. High prevalence of Liddle syndrome phenotype among hypertensive US veterans in Northwest Louisiana. J Clin Hypertens (Greenwich). 2010;12:856-60. [PMID: 21054772] doi:10.1111/j.1751-7176.2010.00359.x CrossrefMedlineGoogle Scholar5. Akintunde A, Nondi J, Gogo K, Jones ESW, Rayner BL, Hackam DG, et al. Physiological phenotyping for personalized therapy of uncontrolled hypertension in Africa. Am J Hypertens. 2017;30:923-30. [PMID: 28472315] doi:10.1093/ajh/hpx066 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Robarts Research Institute, London, Ontario, Canada (J.D.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L18-0025. 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 Eugenia Gkaliagkousi , Panagiota Anyfanti , Antonios Lazaridis , and Stella Douma The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension Jenifer M. Brown and Anand Vaidya The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension Kosuke Inoue and Tetsuo Nishikawa Metrics 15 May 2018Volume 168, Issue 10Page: 753-754KeywordsAldosteroneConflicts of interestDisclosureHypertensionPhenotypesPlasma renin activityPotassiumResistant hypertensionSaltsSodium channels ePublished: 15 May 2018 Issue Published: 15 May 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...