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Abstract 【Objective】To standardize the screening process of patients with primary aldosteronism (PA) to improve the understanding of PA and the diagnostic accuracy of PA. 【Methods】The 204 cases of hypertension patient in our hospital between December 2011 and December 2012 were analyzed retrospectively. We calculated the constituent ratio of PA in all 204 hypertension cases, analyzed the clinical characteristics of these cases including clinical symptoms, laboratory examinations, image examinations, and treatments. Next, we analyzed the difference between the PA patients and the hypertension patients. Afterwards, we calculated the plasm aldosterone to rennin ratio (ARR) and analyzed the specificity sensitivity of different values of ARR and compared the difference of target organ damage between the PA patients and the hypertension patients. Finally, we analyzed the relationship between the length of PA patients and the target organ damage as well as the causes that influence the status of hypertension after the surgery. 【Results】We diagnosed 46 PA patients from hypertension patients by screening of ARR, clinical characteristics, and CT the incidence of PA patients in hypertension was 22.5%. The mean age (45.7±8.9) years; there were male 21 cases and female 25 cases; stage 1 had 3 cases (6.5%), stage 2 had 13 cases (28.3%), stage 3 had 30 cases (65.2%); one of PA patient blood pressure was normal. The average systolic pressure was（178±26.4）mmHg and the average diastolic pressure (111±19.6) was mmHg. We used ARR 20 as the diagnostic cutoff with PAC>15ng/dl, the sensitivity of diagnosis was 85.7%, and the specificity was 84.4%. The PA patients group had more complications than the hypertension patients group. The PA patients group used more antihypertensive drugs than hypertension patients group. 【Conclusion】The incidence of patients with PA was extremely high in stage 2 hypertension, in our study the incidence had reached 20%. ARR have diagnostic value, and with the use of ARR 20 as the diagnostic cutoff with PAC>15ng/dl better sensitivity and specificity can be achieved. The target organs of PA patients were damaged more seriously than hypertension patients. Surgical treatment is good method for PA patients with adrenocotical adenoma; the blood pressure was controlled easily after surgery. Most hypokalemia patients returned to normal. However, if patients had long course, effects would not be good. We advocate early detection, early diagnosis, and early treatment.
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Received: 24 September 2015
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2015, Vol. 32 
