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(Hypertension. 2008;52:e22.)
© 2008 American Heart Association, Inc.

Letters to the Editor

Delay in the Diagnosis of Conn’s Syndrome: A Single-Center Experience Over 30 Years

University Department of Medicine, City Hospital, Birmingham, United Kingdom

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

The study reported by Rossi et al¹ addressed predictors of outcome in aldosterone-producing adenoma (APA) patients postadrenalectomy. The time-dependent process of adverse vascular remodeling, determined by an increased media/lumen ratio of resistance arteries, was hypothesized to predict a poorer response to adrenalectomy. Indeed, the media/lumen ratio and the known duration of hypertension were significant predictors of response to adrenalectomy in APA patients who were categorized into cured, markedly improved, or mildly improved subgroups. In particular, the mean duration of hypertension in the 3 groups was 2.6±0.9, 8.0±1.3, and 17.3±5.0 years, respectively.

We encountered a patient who was referred to us for investigation of hypertension 15 years after first diagnosis.² We confirmed an APA, diameter 3.8 cm, possibly the largest APA in the English literature. We therefore investigated whether the duration of hypertension was related to tumor size, but we found no relationship. We investigated a total of 19 patients with APA and 10 patients with idiopathic hyperaldosteronism (IHA) from our center over the past 30 years. The Table shows the delay in referral from primary care to the hypertension clinic (delay 1), the delay in diagnosis of APA/IHA within the hypertension clinic (delay 2), and the total duration of hypertension to diagnosis of APA/IHA (total delay). We found that the duration of pre-existing hypertension to diagnosis in our APA patients was 8 years, which was very similar to the subgroup of APA patients reported by Rossi et al whom underwent adrenalectomy resulting in a markedly improved BP . . . [Full Text of this Article]

This article has been cited by other articles:

				G. P. Rossi and A. C. Pessina Response to Delay in the Diagnosis of Conn's Syndrome: A Single-Center Experience Over 30 Years Hypertension, September 1, 2008; 52(3): e23 - e23. [Full Text] [PDF]