Primary aldosteronism is common in new-onset T2D with hypertension

  • Hu Y & al.
  • J Clin Endocrinol Metab
  • 01/04/2020

  • Miriam Tucker
  • Clinical Essentials
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Takeaway

  • At least 19% of new-onset type 2 diabetes (T2D) patients with hypertension had primary aldosteronism (PA) in this study.

Why this matters

  • Few studies have addressed this comorbidity.

Study design

  • Total 256 Chinese outpatients with new-onset T2D and hypertension were screened for PA.
  • Patients with aldosterone renin activity ratio (ARR) ≥30 ng/dL/ng/mL/hour and plasma aldosterone concentration (PAC) ≥15 ng/dL underwent confirmatory captopril challenge test (CCT) for PA, with PA diagnostic criteria:
    • After CCT, (1) PAC decreased
  • 3 groups defined: screening test negative, screening test positive/CCT negative, and PA diagnosed.
  • Funding: Hunan Provincial Science and Technology Department.

Key results

  • Positive screening test in 39%, PA diagnosed in 19%.
  • Compared with screening-negative and screening-positive/CCT-negative groups:
    • More PA-diagnosed patients had systolic BP ≥160 mmHg (71% vs 15% and 16%, respectively; P<.001>
    • Fewer had hypertension family history (31% vs 69% and 70%; P<.001>
    • Serum potassium was lower (P<.001 respectively>
  • Compared with screening negative, those screening positive or with a PA diagnosis had:
    • Higher PAC (P<.001>
    • Higher ARR (P<.001 and>
    • Lower plasma renin activity (P<.001>
  • Aldosterone was positively associated with homeostatic model assessment for insulin resistance (P<.01>

Limitations

  • Small sample.
  • Single center.