Clinical Characteristics Of Primary Aldosteronism With Hypokalemia

Objective:To explore the clinical characteristics of primary aldosteronism with hypokalemia,and to provide a basis for early clinical identification of high-risk groups vulnerable to primary aldosteronism with target organ damage.Method:A total of 290 patients with primary aldosteronism(PA)who were hospitalized for hypertension in Fuwai Cardiovascular Disease Hospital of Yunnan Province from September 1,2019 to October 31,2020 and diagnosed by screening and diagnosis test were collected retrospectively.Seventy-seven patients with incomplete clinical data were excluded,and a total of 213 patients were enrolled.General data of all enrolled patients were collected,and laboratory tests such as blood biochemical tests,myocardial injury markers,24h urinary electrolytes,and urinary microalbinin were recorded,as well as indicators related to dynamic blood pressure parameters,echocardiography,cervical vascular ultrasound and arteriosclerosis examination.According to the serum potassium level,all enrolled patients were divided into normal serum potassium group(n=128)and hypokalemia group(n=85).The differences between the two groups and the correlation between the indexes and serum potassium were analyzed.Results:1.From September 1,2019 to October 31,2020,the detection rate of PA was 3.35%(290/8654)in the whole hospital and 16.45%(267/1623)in the hypertension ward of Yunnan Fuwai Cardiovascular Disease Hospital,and the incidence of hypokalemia in PA was 39.91%(85/213).2.Compared with patients in the normal serum potassium group,the levels of TC and HDL-C were significantly decreased in patients in the hypokalemia group(P<0.05),the levels of PAC in supine position,ARR in erect position,24hSBP,nSBP,NT-proBNP and hsTnI were significantly increased(P<0.05).Two groups of patients with gender,age,smoking history,course of the disease,BMI,PRC in supine position,ARR in supine position,PAC in erect position,PRC in erect position,LDL-C,TG,Hcy,FBG,MYO,CK-MB,uric acid,creatinine and 24-hour urinary sodium,24-hour urinary potassium,24-hour urinary protein,urine trace albumin,Ccr,blood pressure circadian rhythm,the highest systolic blood pressure,the highest diastolic blood pressure,mSBP,mDBP,24hDBP,dSBP;dDBP,nDBP,HR,IVST,LVPWT,LVEDD,LVMI,EF,baPWV,IMT and atherosclerosis index had no statistical significance(P>0.05).3.Spearman correlation analysis showed that duration of hypertension,decumbent PAC,decumbent ARR,orthotopic PAC,orthotopic ARR,NT-proBNP,hsTnI,24-hour urinary potassium were negatively correlated with serum potassium level,while creatinine was positively correlated with serum potassium level(P<0.05).4.The results of multivariate linear regression analysis showed that BMI was positively correlated with serum potassium level,while Ccr was negatively correlated with serum potassium level(P<0.05).Conclusions:1.From September 1,2019 to October 31,2020,the detection rate of PA was 3.35%in the whole hospital and 16.45%in the hypertension ward of Yunnan Fuwai Cardiovascular Disease Hospital,and the incidence of hypokalemia in PA was 39.91%.2.Compared with patients without hypokalemia,PA patients with hypokalemia had higher PAC in supine position,ARR in orthostatic position,mean systolic blood pressure throughout the day and at night,and markers of myocardial injury.3.Compared with patients without hypokalemia,PA patients with hypokalemia may be more prone to complications such as myocardial injury and heart failure.