No matter what the disease is, it is all about symptomatic treatment. Your high blood pressure has not been controlled well for so long, have you ever thought that it is probably not symptomatic! In particular, high blood pressure caused by certain diseases can also cause serious damage to organs such as the heart and kidneys.
Proaldosteronism—the neglected culprit of high blood pressure
This disease that induces high blood pressure is orthoaldosteronism.
Primary aldosteronism, also called primary aldosteronism , is a syndrome caused by excessive secretion of aldosterone by the adrenal cortex , the main clinical manifestations are hypertension and hypokalemia. That is to say, there is a problem with our adrenal gland , which secretes too much aldosterone, which leads to excessive potassium excretion in the body and an increase in blood volume .
Excessive loss of blood potassium will cause danger to the patient's cardiovascular, endocrine, digestive and urinary systems, such as diabetes, arrhythmia and other diseases. When the blood volume increases, the pressure on the blood vessel wall will also increase significantly, so it will induce high blood pressure. Moreover, compared with other hypertensive patients , the damage to the heart, kidneys and other organs of patients with primary aldosteronism will be more serious. Therefore, timely inhibition of aldosterone production is the basis for the treatment of primary aldosterone hypertension.
In addition, different from the characteristics of hypertension that can only be relieved but not completely cured, hypertension induced by aldosterone can be cured by controlling the secretion of aldosterone. Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine once reported a case. The patient suffered from protoaldosterone due to excessive aldosterone secretion by adrenal tumor, high blood pressure, and hypokalemia. After symptomatic treatment, The patient's blood pressure returned to normal without taking medicine, and he completely said goodbye to high blood pressure.
Emma:
A study found that about 16%-22% of hypertensive patients are caused by primary aldosteronism. However, the missed diagnosis rate of orthoaldosteronism is very high, and the mechanism of action of our commonly used antihypertensive drugs has no effect on the secretion of aldosterone, that is to say, antihypertensive drugs cannot reduce hypertension caused by orthoaldosterone, so, This is the reason why the antihypertensive effect of some patients with refractory hypertension is not ideal.
The more severe the hypertension, the higher the aldosterone.
The incidence of orthoaldosteronism is closely related to the increase of blood pressure.
From a study published by a team at Harvard Medical SchoolBrigham and Women's Hospital, the more severe the hypertension, the higher the aldosterone levels in the patient's body.
The researchers conducted 24-hour urine tests in 289 normotensive subjects, 115 untreated stage 1 hypertension subjects, 203 stage 2 hypertensive subjects, and 408 treatment-resistant hypertensive subjects. Analysis of sodium test results showed that the average 24-hour urinary aldosterone levels in patients with normal blood pressure, stage 1 hypertension, stage 2 hypertension, and refractory hypertension were 6.5 μg, 7.3 μg, 9.5 μg, and 14.6 μg, respectively; The prevalence of primary aldosteronism was 11.3%, 15.7%, 21.6% and 22%. It can be seen that the higher the blood pressure and the higher the average level of urinary aldosterone, the greater the probability of detection of primary aldosterone.
The researchers said that although orthoaldosteronism is currently only considered to be one of the rare causes of hypertension, these findings could almost redefine orthoaldosteronism as an important pathogenesis of essential hypertension It is hoped that this finding will lead to an increase in the rate of hypertensive patients receiving systematic screening, thereby increasing the efficacy of hypertensive treatment in patients with primary aldosteronism.
These 6 types of hypertensive patients need to be screened for orthoaldosteronism
Hypertension caused by orthoaldosteronism can be cured. In the following cases, it is recommended to go to the hospital for primary aldehyde screening:
1. Persistent blood pressure>160/100 mmHg, refractory hypertension.
2. Hypertension with hypokalemia.
3. Hypertension with adrenal tumor.
4. Hypertensive patients with a family history of early-onset hypertensionfamily history or early-onset (<40>cerebrovascular accident.
5. Hypertensive first-degree relatives of patients with orthoaldosteronism.
6. Hypertension with obstructive sleep apnea.
