原发性醛固酮增多症
医学
2型糖尿病
糖尿病
内科学
抵抗性高血压
内分泌学
儿科
醛固酮
血压
作者
Ernestini Tyfoxylou,Nikolaos Voulgaris,Christos Gravvanis,Sophia Vlachou,Αthina Markou,Labrini Papanastasiou,Nikolaοs Tentolouris,Eva Kassi,Gregory Kaltsas,George P. Chrousos,George Piaditis
出处
期刊:Biomedicines
[Multidisciplinary Digital Publishing Institute]
日期:2022-09-16
卷期号:10 (9): 2308-2308
被引量:7
标识
DOI:10.3390/biomedicines10092308
摘要
Primary aldosteronism (PA) is the most common cause of endocrine hypertension. The prevalence of hypertension is higher in patients with diabetes mellitus-2 (DM-2). Following the limited existing data, we prospectively investigated the prevalence of aldosterone excess either as autonomous secretion (PA) or as a hyper-response to stress in hypertensive patients with DM-2 (HDM-2). A total of 137 HDM-2 patients and 61 non-diabetics with essential hypertension who served as controls (EH-C) underwent a combined, overnight diagnostic test, the Dexamethasone–captopril–valsartan test (DCVT) used for the diagnosis of PA and an ultralow dose (0.3 μg) ACTH stimulation test to identify an exaggerated aldosterone response to ACTH stimulation. Twenty-three normotensive individuals served as controls (NC) to define the normal response of aldosterone (ALD) and aldosterone-to-renin ratio (ARR) to the ultralow dose ACTH test. Using post-DCVTALD and ARR from the EH-C, and post-ACTH peak ALD and ARR from the NC, 47 (34.3%) HDM-2 patients were found to have PA, whereas 6 (10.4%) HDM-2 patients without PA (DCVT-negative) exhibited an exaggerated aldosterone response to stress—a prevalence much higher than ever reported. Treatment with mineralocorticoid receptor antagonists (MRAs) induced a significant and permanent reduction of BP in all HDM-2 patients. Early diagnosis and targeted treatment of PA is crucial to prevent any aggravating effect on chronic diabetic complications.
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