[PP.25.19] TREATMENTS OF HYPERTENSION DUE TO PRIMARY HYPERALDOSTERNISM: EFFICACY, EFFICIENCE AND ADVERSE EFFECTS

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Abstract

Objective:

Primary Hyperaldosteronism (PA) (10% of all hypertensive patients) is characterized by the Conn's Syndrome or by bilateral hyperplasia. The aim of this observational, retrospective study was to investigate the different strategy to diagnose and to treat the PA and we evaluate the efficiency and adverse effects of both.

Design and method:

We conducted a retrospective study, considering patientsdiagosed with PA in our department from 1992 to 2014. 64 patients were included: 26 with conn adenoma and 38 with bilateral adrenal hyperplasia.

Results:

Patient suffering from Conn Adenoma (CA) (n=26) and from Bilateral Hyperplasia of adrenal gland (BH) (n = 38) were similar in age, systolic blood pressure or diastolic blood pressure and for the sex. The delay in years between the diagnostic of Hypertension and PA was different (9,3 ± 6,7 for CA vs 13,9 ± 9,3 BH p = 0,034). Kaliemia was lower in CA (2,9 ± 0,5) vs BH(3,4 ± 0,5) p < 0,001. Spironolactone was the main treatment in the two groups. 50% of the patient in the CA group underwent a surgery and all other patients were medically treated. Hypertension control was higher in CA 76,9% vs HB 52,6% p = 0,03. There was no difference between the two groups on hypokalemia control and 15,4% of patients took potassium supplementation at the end of the follow up. Main side effects were gynecomastia 20,3% and sexual dysfunction 12,5% in all the population with PA. Mean number of treatment during the last visit was lower in CA group than in the BH group, p < 0,001. We used more beta-blockers, thiazide diuretics and angiotensin-converting enzyme inhibitors in the BH group than in the CA group.

Conclusions:

Diagnosis of PA is performed with long delay, especially for BH. Moreover, adverse events and hypertension control are worse in BH. Our study shows that the management of those patients still needs to be improved.

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