Comparing the Prevalence of Primary Aldosteronism in Hypertensive Diabetic and Non-diabetic Patients

Background: Primary aldosteronism is the most common cause of secondary hypertension in humans. Its prevalence is estimated to be 10-15% among hypertensive patients. It is also associated with insulin resistance and diabetes mellitus. The aim of our study was to compare the prevalence of primary aldosteronism in hypertensive patients with presence of diabetes mellitus. Methods: We reviewed retrospectively the clinical records of 104 hypertensive patients for whom we also measured plasma renin activity (PRA) and plasma aldosterone concentrations (PAC). Results: Among 104 hypertensive patients, 44 had diabetes and 60 did not. There were no significant differences in clinical characteristics between non-diabetic and diabetic patients except for age and the number of antihypertensive agents. Patients with target organ damage were more common among diabetic patients. There was no correlation between PAC and the number of target organs damaged. In addition, Four patients from the non-diabetic and two from the diabetic group had a rat io over 30 for PRA/PAC and a PAC of over 15 ng/dL. Two non-diabetic patients and one diabetic patient were found, on abdomen CT, to have an adrenal adenoma. The rest of the patients refused further tests. Conclusion: The prevalence of primary aldosteronism in diabetic patients does not differ significantly from that in non-diabetic patients. Therefore, the present routine screening test for primary aldosteronism in