Recent studies suggested that the prevalence of primary aldosteronism (PA) in hypertensive population may be as high as 5–15%, using the aldosterone-renin-ratio (ARR) as a screening test. In a separate study, Ito et al systemically screened adult subjects who agreed to a general health screening of PA and found that 18.5% of the subjects had an ARR>20, suggesting “probable PA”. The objective of this study was to determine the prevalence of raised ARR in Malaysia.Design and Method:
This was a cross sectional study using the World Health Survey Kish tables to select eligible subjects (≥18 years old) from each household. Their social demography, past medical history, anthropometric measurement and blood pressure were recorded. Blood was withdrawn for Aldosterone, Renin, Creatinine and potassium. Raised ARR is defined as ARR≥20. Hypertension is defined as blood pressure consistently ≥140/90 mmHg and/or when anti-hypertensive drugs were initiated. Data was analysed using SPSS 23, using Pearson's Test with significant value of 0.05.Results:
A total of 1349 subjects (age 51 ± 16.1) were recruited. 549 (40.7%) were hypertensive, and 800 (59.3%) were non-hypertensive. 368 (67%) were known hypertensive while 181 (33%) were newly diagnosed hypertension. From the known hypertensive, 309 (84%) were on treatment while 59 (16%) were not on treatment. There were a total of 175 (13%) subjects with raised ARR, 92 (52.6%) were hypertensive while 83 (47.4%) were normotensive. Only 9 (5.1%) subjects had hypokalaemia. The main clinical characteristics of subjects with raised ARR are shown in Table 1. Subjects with raised ARR were significantly older, have hypertension with higher systolic blood pressure and have suppressed renin.Conclusions:
The prevalence of raised ARR in Malaysia was 13% with minority of them were hypokalaemic. This is in concordance with previous report. These individuals were older, with higher systolic blood pressure and have suppressed renin.