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Primary aldosteronism (PA) is a known but underdiagnosed cause of high blood pressure. It is estimated that more than 10% of all people with high blood pressure (HT) suffer from PA, which is often caused by aldosterone-producing adrenal cortical tumors (APAs).
In a pilot study with 35 patients with APAs leading to hypertension, the investigators have identified a genetic variant in a presumed Calcium-channel gene. The variant was significantly overrepresented in patients with APAs compared to the normal population (12% compared to approximately 4%). Interestingly, all patients having APAs and the variant were men.
The SCAPIS study is a world-unique Swedish research study in the field of heart/lungs, in which 30,000 randomly selected people between the ages of 50-64 participated. The study is a collaboration between the universities of Gothenburg, Lund, Linköping, Uppsala and Umeå, as well as the Karolinska Institute in Stockholm. In Linköping, about 5,000 persons participated.
The investigators have now screened 4762 persons from the SCAPIS study for this variant and found it in little less than 6%. Overall, patients with the variant had more often been diagnosed with HT and were mote often treated for HT as well. Interestingly, this difference was only found in men.
The investigators now want to investigate the following:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Presence of unilateral primary aldosteronism in patients with genetic variant and hypertension | Active Comparator | Unilateral adrenalectomy is offered |
|
| Presence of bilateral primary aldosteronism in patients with genetic variant and hypertension | No Intervention | Medical treatment is offered |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Adrenalectomy | Procedure | Surgical removal of patients with unilateral primary aldosteronism in patients selected by the presence of a genetic variant and hypertension |
|
| Measure | Description | Time Frame |
|---|---|---|
| Normal aldosterone-renin-ratio | 6 months following surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Blood pressure both systolic and diastolic | 6 months after surgery | |
| Number of antihypertensive drugs | 6 months following surgery | |
| Normal potassium level |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Linköping University Hospital | Linköping | Östergötland County | 58185 | Sweden |
all IPD that underlie results in a publication
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| D006929 | Hyperaldosteronism |
| D020022 | Genetic Predisposition to Disease |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D000308 | Adrenocortical Hyperfunction |
| D000307 | Adrenal Gland Diseases |
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| ID | Term |
|---|---|
| D000315 | Adrenalectomy |
| ID | Term |
|---|---|
| D013507 | Endocrine Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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| 6 months postoperatively |
| D004700 | Endocrine System Diseases |
| D004198 | Disease Susceptibility |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |