Retrospective evaluation of patients diagnosed with primary hyperaldosteronism in the endocrinology and metabolic diseases polyclinic between 2010-2021

Objective: In this study, it was aimed to retrospectively evaluate the demographic characteristics, clinical and laboratory data, and treatment options of patients with primary hyperaldosteronism (PH). Materials and Methods: The study included 42 patients diagnosed with PH and evaluated in the Endocrinology and Metabolism Diseases Polyclinic of Karadeniz Technical University Faculty of Medicine between 2010-2021. Demographic characteristics of the patients, laboratory data and clinical characteristics at the time of diagnosis, and selected diagnosis and treatment methods were reviewed retrospectively. Findings: In our study, 66.7% of the patients were female and 33.3% were male. The mean age of the patients at the time of diagnosis was 50±11.2 years. At the time of diagnosis, 21.9% of the patients had diabetes mellitus (DM), 2.4% had coronary artery disease (CAD), 2.4% had atrial fibrillation (AF), 2.4% had cerebrovascular accident (CVA). Mean plasma aldosterone concentration (PAC) at the time of diagnosis was 40.7±25 ng/dL, mean plasma renin activity (PRA) was 0.6±0.7 ng/ml/h, and mean aldosterone/renin ratio (ARO) was 172.9±212.5. The mean potassium level of the patients was 3.6±0.7 mEq/L. As a result of the radiological evaluation, 61.9% of the patients had adrenal adenoma, 14.2% had adrenal hyperplasia, 4.7% had bilateral diffuse thickening, and 2.3% had myelolipoma; no adrenal lesion was detected in 19%. 76% of patients with adrenal adenoma were women, and 1% of patients with adrenal hyperplasia were women. Surgery was performed in 40.4% of the patients, and 94.1% of these patients had adenoma and 5.8% had hyperplasia. Results: In our study, 61.9% of primary hyperaldosteronism patients had adrenal adenoma, 14.2% had adrenal hyperplasia, 4.7% had bilateral diffuse thickening, and 2.3% had myelolipoma; no adrenal lesion was detected in 19%. At the time of diagnosis, 21.9% of the patients had DM, 2.4% CAD, 2.4% AF and 2.4% CVA. These findings were found to be similar to the literature. It is important to reduce the comorbidities that may occur with the early diagnosis of the disease and to prevent possible end organ damage. In our clinical practice, we should not overlook the cases that constitute a primary hyperaldosteronism screening indication. Keywords: Adrenal hyperplasia, Adrenal mass and hypertension, Aldosterone-producing adenoma, Primary hyperaldosteronism, Seconder hypertension