诊断学理论与实践2025，Vol.24Issue(4)：449-454,6.DOI:10.16150/j.1671-2870.2025.04.012
原发性醛固酮增多症中难治性高血压患者的临床特征分析
Analysis of clinical characteristics of patients with resistant hypertension in primary aldosteronism
摘要
Abstract
Objective To compare the clinical characteristics of resistant hypertension(RH)in patients with pri-mary aldosteronism(PA)and essential hypertension(EH),and to analyze the risk factors associated with RH.Methods From January 2010 to December 2014,a total of 2 138 consecutive patients referred to our department for screening the causes of hypertension were enrolled.The prevalence of RH was calculated.Among them,385 patients(18.0%)were classi-fied into the PA group,and 385 patients with EH matched based on age,gender,blood pressure(BP)levels were selected as the EH group.The prevalence of RH and general clinical data between the two groups were compared,and the relationship between RH and left ventricular hypertrophy(LVH)in patients with PA and EH was analyzed.Multiple linear regression analysis was used to identify risk factors for RH.Results RH accounted for approximately 26.0%(556/2 138)of the inpa-tients in the department of hypertension,and 9.2%(51/556)of these RH patients were diagnosed with PA.The prevalence of RH in the PA group was significantly lower than that in the EH group(13.2%vs 35.3%,P<0.001).There was no signifi-cant difference in the incidence of LVH between RH and non-RH patients in the PA group(59.3%vs 56.9%).In the EH group,the incidence of LVH was much higher in RH patients than in non-RH patients(54.3%vs 30.1%,P<0.05).Multi-variate regression analysis showed that office systolic blood pressure,male gender,and diabetes were independent risk fac-tors for RH in PA patients.The occurrence of RH in the EH group was independently correlated with age,hypertension course,LVH,and creatinine level(P<0.05).Conclusions The prevalence of RH among hypertensive inpatients is approxi-mately 26.0%.In PA and EH patients with comparable BP levels,the prevalence of RH is higher in EH patients,while the incidence of LVH is higher in PA patients and is not related to the presence of RH.In the EH group,RH patients have a higher incidence of LVH than non-RH patients.Office systolic blood pressure,male gender,and diabetes are important pre-dictive factors for RH in PA patients.关键词
难治性高血压/原发性醛固酮增多症/原发性高血压Key words
Resistant hypertension/Primary aldosteronism/Essential hypertension分类
医药卫生引用本文复制引用
马毓,吴祁红,亢园园,洪墨纳,唐晓峰,高平进,许建忠,王继光..原发性醛固酮增多症中难治性高血压患者的临床特征分析[J].诊断学理论与实践,2025,24(4):449-454,6.基金项目
国家自然科学基金(U21A20354) （U21A20354）
上海市卫健委青年基金(20214Y0229) （20214Y0229）
