[ Hypertension artérielle et hypokaliémie: Association significative ]
Volume 17, Issue 3, August 2016, Pages 819–823
Aziza LAARJE1, Miriem BORYAL2, Amina ASADI3, Nadia EZZOUBIR4, Anass ASSAIDI5, and Rachida Habbal6
1 Service de Cardiologie, CHU Ibn Rochd, Casablanca, Morocco
2 Service de Néphrologie, CHU Ibn Rochd, Casablanca, Morocco
3 Service de Cardiologie, CHU Ibn Rochd, Casablanca, Morocco
4 Service de Cardiologie, CHU Ibn Rochd, Casablanca, Morocco
5 Service de Cardiologie, CHU Ibn Rochd, Casablanca, Morocco
6 Laboratory of Human Genetics and Molecular Pathology, University Hassan II, Faculty of Medicine, Casablanca, Morocco
Original language: French
Copyright © 2016 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The arterial hypertension (HTA) of endocrine origin, account for over half of secondary hypertension causes. This etiological entity comprises several distinct disorders, the most common being primary aldosteronism (PAHs). Its symptoms are very unspecific, but the association of hypertension with hypokalemia, should guide the investigations to confirm PAH. We report the case of a woman of 40 years old, who has a resistant hypertension to triple therapy, the systolic blood pressure is 170 mmHg and diastolic blood pressure is 120 mmHg, with hypokalemia 1.9 mEq /L, and a high urinary potassium at 87 mEq /24h. The report Aldosterone / Renin was very high. The scan showed an adrenal mass of 23.3 mm, without abnormality of the renal arteries. A treatment based on Spironolactone has been established, and adrenalectomy thereafter. The evolution was marked by normalization of blood pressure, of serum potassium, and the rate of aldosterone. Primary aldosteronism by Conn adenoma, now covers 10% of hypertensive patients, and should be suspected when hypokalemia is present in untreated hypertensive, or resistant to antihypertensive drugs. The diagnostics have refined: they are now more sensitive, specific and indications are more accurate, allowing better management of patients.
Author Keywords: Hypertension, Primary aldosteronism, Hypokalemia, Conn's syndrome, spironolactone.
Volume 17, Issue 3, August 2016, Pages 819–823
Aziza LAARJE1, Miriem BORYAL2, Amina ASADI3, Nadia EZZOUBIR4, Anass ASSAIDI5, and Rachida Habbal6
1 Service de Cardiologie, CHU Ibn Rochd, Casablanca, Morocco
2 Service de Néphrologie, CHU Ibn Rochd, Casablanca, Morocco
3 Service de Cardiologie, CHU Ibn Rochd, Casablanca, Morocco
4 Service de Cardiologie, CHU Ibn Rochd, Casablanca, Morocco
5 Service de Cardiologie, CHU Ibn Rochd, Casablanca, Morocco
6 Laboratory of Human Genetics and Molecular Pathology, University Hassan II, Faculty of Medicine, Casablanca, Morocco
Original language: French
Copyright © 2016 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The arterial hypertension (HTA) of endocrine origin, account for over half of secondary hypertension causes. This etiological entity comprises several distinct disorders, the most common being primary aldosteronism (PAHs). Its symptoms are very unspecific, but the association of hypertension with hypokalemia, should guide the investigations to confirm PAH. We report the case of a woman of 40 years old, who has a resistant hypertension to triple therapy, the systolic blood pressure is 170 mmHg and diastolic blood pressure is 120 mmHg, with hypokalemia 1.9 mEq /L, and a high urinary potassium at 87 mEq /24h. The report Aldosterone / Renin was very high. The scan showed an adrenal mass of 23.3 mm, without abnormality of the renal arteries. A treatment based on Spironolactone has been established, and adrenalectomy thereafter. The evolution was marked by normalization of blood pressure, of serum potassium, and the rate of aldosterone. Primary aldosteronism by Conn adenoma, now covers 10% of hypertensive patients, and should be suspected when hypokalemia is present in untreated hypertensive, or resistant to antihypertensive drugs. The diagnostics have refined: they are now more sensitive, specific and indications are more accurate, allowing better management of patients.
Author Keywords: Hypertension, Primary aldosteronism, Hypokalemia, Conn's syndrome, spironolactone.
Abstract: (french)
Les hypertensions artérielles (HTA) d’origine endocrine représentent plus de la moitié des causes secondaires d’HTA. Cette entité étiologique regroupe plusieurs pathologies distinctes, la plus fréquente étant l’hyperaldostéronisme primaire (HAP). Sa symptomatologie est très peu spécifique mais l’association de l’hypertension artérielle avec l’hypokaliémie doit orienter les investigations pour confirmer l’HAP. Nous rapportons l’observation d’une femme de 40 ans qui présente une HTA résistante à une trithérapie, la pression artérielle est de 170 mmHg de systolique et de 120 mmHg de diastolique avec une hypokaliémie à 1,9 mEq/l et une kaliurèse élevée à 87 mEq/24h. Le rapport Aldostérone/ Rénine était très élevé. Le scanner a montré une masse surrénalienne de 23,3 mm sans anomalie des artères rénales. Un traitement à base de Spironolactone a été instauré et une surrénalectomie par la suite. L’évolution a été marquée par la normalisation des chiffres tensionnels, de la kaliémie et du taux d’Aldostérone. L’hyperaldostéronisme primaire par adénome de conn concerne aujourd’hui 10% des patients hypertendus et doit être suspectée lorsqu’une hypokaliémie est présente chez hypertendu non traité ou qui résiste aux traitements antihypertenseurs. Les moyens diagnostiques se sont affinés : ils sont aujourd’hui plus sensible, spécifique et leurs indications sont plus précises, permettant une meilleure prise en charge des patients.
Author Keywords: Hypertension artérielle, Hyperaldostéronisme primaire, Hypokaliémie, Adénome de Conn, spironolactone.
How to Cite this Article
Aziza LAARJE, Miriem BORYAL, Amina ASADI, Nadia EZZOUBIR, Anass ASSAIDI, and Rachida Habbal, “Hypertension and hypokalemia: Significant Association,” International Journal of Innovation and Applied Studies, vol. 17, no. 3, pp. 819–823, August 2016.
