PA and hypertension, a new Swedish study.
December 31, 2010 4:56 AM Subscribe
A new explanation for some hypertension cases. I found the headline "Binjure kan ge högt blodtryck" (adrenal gland can give hypertension) in today's local paper. The article (which is in Swedish, and unfortunately not on Borås Tidnings website at this moment) - refers to a dissertation by Christina Westerdahl, the English abstract of which is in the link above.
The condition that caused hypertension in 5.5% out of 200 test persons is (clearly) easily testable and treatable "PA," Primary aldosteronism, which is characterized by an inappropriate aldosterone secretion. What's new about this is that the percentage of PA cases causing hypertension is much higher than traditionally known. First thing for the new year: get a test?
The condition that caused hypertension in 5.5% out of 200 test persons is (clearly) easily testable and treatable "PA," Primary aldosteronism, which is characterized by an inappropriate aldosterone secretion. What's new about this is that the percentage of PA cases causing hypertension is much higher than traditionally known. First thing for the new year: get a test?
This post was deleted for the following reason: We need more than an abstract to really have a post about this. -- cortex
Recent international screening studies have found a high prevalence of the disease accounting for up to 10 % of hypertensive individuals. Thus, PA is recognized to be the most common cause of secondary hypertension. However, the prevalence of PA varies between study populations and the frequency among hypertensive patients in primary health care remains uncertain. When we planned these studies, no studies had previously been done in Swedish primary health care.
So not a new explanation.
The condition that caused hypertension in 5.5% out of 200 test persons is (clearly) easily testable and treatable "PA," Primary aldosteronism, which is characterized by an inappropriate aldosterone secretion. What's new about this is that the percentage of PA cases causing hypertension is much higher than traditionally known. First thing for the new year: get a test?
No, don't rush out and get a test. Never rush out and get a test if you have no index of suspicion. If you have 'essential' hypertension that isn't responding to first-line medical treatments and lifestyle changes, maybe a trial of spironolactone might be worth a try. But getting tested for the hell of it is almost never a good idea, barring a few screening tests that have proven to be globally valuable. For hypertension, we already have a good one: it's called repeated elevated measurement with the blood pressure cuff.
Besides, per the abstract tests for primary aldosteronism aren't standardized and it's not clear at what point elevated aldosterone will necessarily lead to hypertension. While aldosterone and high blood pressure are correlated in these patients, and there is a good mechanistic explanation for how aldosterone could cause hypertension, the causal link is not clearly established even in the cases where aldosterone is high. For example, it's entirely possible that lower-level aldosterone elevations are secondary to some other cause that leads to hypertension on its own, though this violates Occam's razor.
posted by monocyte at 6:42 AM on December 31, 2010
So not a new explanation.
The condition that caused hypertension in 5.5% out of 200 test persons is (clearly) easily testable and treatable "PA," Primary aldosteronism, which is characterized by an inappropriate aldosterone secretion. What's new about this is that the percentage of PA cases causing hypertension is much higher than traditionally known. First thing for the new year: get a test?
No, don't rush out and get a test. Never rush out and get a test if you have no index of suspicion. If you have 'essential' hypertension that isn't responding to first-line medical treatments and lifestyle changes, maybe a trial of spironolactone might be worth a try. But getting tested for the hell of it is almost never a good idea, barring a few screening tests that have proven to be globally valuable. For hypertension, we already have a good one: it's called repeated elevated measurement with the blood pressure cuff.
Besides, per the abstract tests for primary aldosteronism aren't standardized and it's not clear at what point elevated aldosterone will necessarily lead to hypertension. While aldosterone and high blood pressure are correlated in these patients, and there is a good mechanistic explanation for how aldosterone could cause hypertension, the causal link is not clearly established even in the cases where aldosterone is high. For example, it's entirely possible that lower-level aldosterone elevations are secondary to some other cause that leads to hypertension on its own, though this violates Occam's razor.
posted by monocyte at 6:42 AM on December 31, 2010
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posted by Coobeastie at 6:22 AM on December 31, 2010