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High Prevalence of Primary Aldosteronism in Patients with Type 2 Diabetes Mellitus and Hypertension

Primary aldosteronism (PA) is the most common cause of endocrine hypertension. The prevalence of hypertension is higher in patients with diabetes mellitus-2 (DM-2). Following the limited existing data, we prospectively investigated the prevalence of aldosterone excess either as autonomous secretion...

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Autores principales: Tyfoxylou, Ernestini, Voulgaris, Nick, Gravvanis, Chris, Vlachou, Sophia, Markou, Athina, Papanastasiou, Labrini, Tentolouris, Nikolaos, Kassi, Eva, Kaltsas, Gregory, Chrousos, George P., Piaditis, George P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9496555/
https://www.ncbi.nlm.nih.gov/pubmed/36140406
http://dx.doi.org/10.3390/biomedicines10092308
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author Tyfoxylou, Ernestini
Voulgaris, Nick
Gravvanis, Chris
Vlachou, Sophia
Markou, Athina
Papanastasiou, Labrini
Tentolouris, Nikolaos
Kassi, Eva
Kaltsas, Gregory
Chrousos, George P.
Piaditis, George P.
author_facet Tyfoxylou, Ernestini
Voulgaris, Nick
Gravvanis, Chris
Vlachou, Sophia
Markou, Athina
Papanastasiou, Labrini
Tentolouris, Nikolaos
Kassi, Eva
Kaltsas, Gregory
Chrousos, George P.
Piaditis, George P.
author_sort Tyfoxylou, Ernestini
collection PubMed
description Primary aldosteronism (PA) is the most common cause of endocrine hypertension. The prevalence of hypertension is higher in patients with diabetes mellitus-2 (DM-2). Following the limited existing data, we prospectively investigated the prevalence of aldosterone excess either as autonomous secretion (PA) or as a hyper-response to stress in hypertensive patients with DM-2 (HDM-2). A total of 137 HDM-2 patients and 61 non-diabetics with essential hypertension who served as controls (EH-C) underwent a combined, overnight diagnostic test, the Dexamethasone–captopril–valsartan test (DCVT) used for the diagnosis of PA and an ultralow dose (0.3 μg) ACTH stimulation test to identify an exaggerated aldosterone response to ACTH stimulation. Twenty-three normotensive individuals served as controls (NC) to define the normal response of aldosterone (ALD) and aldosterone-to-renin ratio (ARR) to the ultralow dose ACTH test. Using post-DCVTALD and ARR from the EH-C, and post-ACTH peak ALD and ARR from the NC, 47 (34.3%) HDM-2 patients were found to have PA, whereas 6 (10.4%) HDM-2 patients without PA (DCVT-negative) exhibited an exaggerated aldosterone response to stress—a prevalence much higher than ever reported. Treatment with mineralocorticoid receptor antagonists (MRAs) induced a significant and permanent reduction of BP in all HDM-2 patients. Early diagnosis and targeted treatment of PA is crucial to prevent any aggravating effect on chronic diabetic complications.
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spelling pubmed-94965552022-09-23 High Prevalence of Primary Aldosteronism in Patients with Type 2 Diabetes Mellitus and Hypertension Tyfoxylou, Ernestini Voulgaris, Nick Gravvanis, Chris Vlachou, Sophia Markou, Athina Papanastasiou, Labrini Tentolouris, Nikolaos Kassi, Eva Kaltsas, Gregory Chrousos, George P. Piaditis, George P. Biomedicines Article Primary aldosteronism (PA) is the most common cause of endocrine hypertension. The prevalence of hypertension is higher in patients with diabetes mellitus-2 (DM-2). Following the limited existing data, we prospectively investigated the prevalence of aldosterone excess either as autonomous secretion (PA) or as a hyper-response to stress in hypertensive patients with DM-2 (HDM-2). A total of 137 HDM-2 patients and 61 non-diabetics with essential hypertension who served as controls (EH-C) underwent a combined, overnight diagnostic test, the Dexamethasone–captopril–valsartan test (DCVT) used for the diagnosis of PA and an ultralow dose (0.3 μg) ACTH stimulation test to identify an exaggerated aldosterone response to ACTH stimulation. Twenty-three normotensive individuals served as controls (NC) to define the normal response of aldosterone (ALD) and aldosterone-to-renin ratio (ARR) to the ultralow dose ACTH test. Using post-DCVTALD and ARR from the EH-C, and post-ACTH peak ALD and ARR from the NC, 47 (34.3%) HDM-2 patients were found to have PA, whereas 6 (10.4%) HDM-2 patients without PA (DCVT-negative) exhibited an exaggerated aldosterone response to stress—a prevalence much higher than ever reported. Treatment with mineralocorticoid receptor antagonists (MRAs) induced a significant and permanent reduction of BP in all HDM-2 patients. Early diagnosis and targeted treatment of PA is crucial to prevent any aggravating effect on chronic diabetic complications. MDPI 2022-09-16 /pmc/articles/PMC9496555/ /pubmed/36140406 http://dx.doi.org/10.3390/biomedicines10092308 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tyfoxylou, Ernestini
Voulgaris, Nick
Gravvanis, Chris
Vlachou, Sophia
Markou, Athina
Papanastasiou, Labrini
Tentolouris, Nikolaos
Kassi, Eva
Kaltsas, Gregory
Chrousos, George P.
Piaditis, George P.
High Prevalence of Primary Aldosteronism in Patients with Type 2 Diabetes Mellitus and Hypertension
title High Prevalence of Primary Aldosteronism in Patients with Type 2 Diabetes Mellitus and Hypertension
title_full High Prevalence of Primary Aldosteronism in Patients with Type 2 Diabetes Mellitus and Hypertension
title_fullStr High Prevalence of Primary Aldosteronism in Patients with Type 2 Diabetes Mellitus and Hypertension
title_full_unstemmed High Prevalence of Primary Aldosteronism in Patients with Type 2 Diabetes Mellitus and Hypertension
title_short High Prevalence of Primary Aldosteronism in Patients with Type 2 Diabetes Mellitus and Hypertension
title_sort high prevalence of primary aldosteronism in patients with type 2 diabetes mellitus and hypertension
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9496555/
https://www.ncbi.nlm.nih.gov/pubmed/36140406
http://dx.doi.org/10.3390/biomedicines10092308
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