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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9496555 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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