Our aim is to determine center-specific features of diagnosis of primary aldosteronism and compare the two Japanese diagnostic criterions.Design and Method:
We retrospectively analyzed data of sixty one suspected patients with primary aldosteronism who admitted to cardiology department of Mie University Hospital from 2012 to 2015. PA was defined according to the report of the guidelines for diagnosis and treatment of PA: the Japanese Society of Hypertension (JSH) 2011 and the Japan Endocrine Society (JES) 2009 respectively.Results:
We studied 27 men (44%) and 34 women; mean age: 60.2 years. The number of subjects has increased (4, 12, 15 and 30 cases/ year). We could diagnose 23 and 31 patients with PA according to the diagnostic criteria of JSH and JES respectively. 17 cases fulfill both the criterions. We could perform in 15 cases all three kinds of tests including saline loading test, captopril test and intravenous furosemide test.The number of patients with idiopathic hypertension was 17. We explained 45 patients who were positive at least one stress examination about adrenal venous sampling (AVS) and 34 patients (76%) agreed that AVS was performed. The examination of AVS revealed 5 aldosterone producing adenoma, 26 idiopathic hyperaldosteronism and one unilateral hyperaldosteronism. We could not reach at the final diagnosis in one patient due to the failed AVS. In all 32 patients with successful AVS, we could observe the absolute value of aldosterone more than 14,000 pg/dl in at least one adrenal vein after the stimulation with ACTH. The criteria of JSH was fulfilled in 19 patients and not fulfilled in 13 patients, whereas the criteria of JES was fulfilled in at least 22 cases.Conclusions:
We see more patients with primary aldosteronism mainly due to idiopathic bilateral hyperaldosteronism. The sensitivity of diagnostic criteria of JSH was lower than that of JES.