To explore the screening, positive rate and curative effect observation after special treatment for primary aldosteronism (PA) in hypertensive in-patients with diabetes mellitus.

One hundred and seventy-eight hypertensive in-patients with diabetes were screened for PA.Patients with aldosterone/renin acrivity ≥554 pmol/L·[μg/(L·h)]^-1 were defined the positive screening group, and remains were the negative screening group.PA was considered according on plasma aldosterone concentration (PAC) ≥138.5 pmol/L and PA was defined with PAC≥277.0 pmol/L after saline infusion test in the positive screening group.

The level of potassium [(3.7±0.4)mmol/L] in the positive screening group was lower than that [(3.9±0.4)mmol/L] in the negative group, and the difference was statistically significant (t=-3.40, P<0.01). The prevalence of PA ranged from 14.0% to 23.0% respectively, due to 41 PA patients with PAC≥138.5 pmol/L and 25 PA patients with PAC≥277.0 pmol/L.Twenty-three patients with PA accepted the adrenal vein sampling (AVS), the operative successful ratio was 91.3%, 6 patients were defined on unilateral adrenal PA, 3 patients accepted adrenalectomy, 2 patients with adrenal producing adenoma and one patient with unilateral nodule hyperplasia were identified via the pathological diagnose after surgery.Twenty-three patients with PA, who had been performed AVS, were followed up 1~2 years after having accepted surgery or mineralocorticoid receptor antagonist.The level of systolic blood pressure [(132.0±7.67)mmHg] after treatment was lower than that [(150.0±14.0)mmHg] before treatment, the difference was statistically significant (t=5.63, P<0.01). The level of diastolic blood pressure [(85.0±7.0)mmHg] after treatment was lower than that [(96.0±5.0)mmHg] before treatment, and the difference was statistically significant (t=5.16, P<0.01). The level of potassium [(4.0±0.3)mmol/L] after treatment was higher than that [(3.5±0.4)mmol/L] before treatment, and the difference was statistically significant (t=-5.45, P<0.01).

A considerable amount PA patients exist in hypertensive subjects with diabetes mellitus.Screening and management for PA are suggested in these patients and the curative effect is affirmed.