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Journal of Case Reports
Hypertension with Metabolic Alkalosis and Hypokalaemia - Could it be Aldosterone?
James Cheng Jiang1, Ronald Castelino2,3, Surjit Tarafdar1,4,5
1Acute Medical Unit and Departments of 3Pharmacy and 4Renal Medicine, Blacktown Hospital, NSW 2148, Australia; 2Faculty of Medicine and Health, University of Sydney, NSW 2148, Australia; 5School of Medicine, Western Sydney University, Sydney, Australia.
Corresponding Author:
Dr. Surjit Tarafdar
Email: surjit.tarafdar@health.nsw.gov.au
Received: 14-JAN-2019 Accepted: 03-MAR-2019 Published Online: 20-MAR-2019
DOI: http://dx.doi.org/10.17659/01.2019.0015
Background: Hypertension has a worldwide prevalence of 31% and contributes markedly to death from stroke and coronary heart disease. Up to 10% of hypertensive patients have secondary hypertension; an even higher prevalence is present amongst patients below the age of 30. The two commonest causes of secondary hypertension, primary aldosteronism and renovascular disease, may both present with metabolic alkalosis and/or hypokalaemia. While both conditions are associated with raised plasma aldosterone, plasma renin concentration is low in primary aldosteronism and high in renovascular hypertension, giving rise to the characteristically high plasma aldosterone concentration: plasma renin concentration (>30:1) in the former. Case Report: We hereby report two hypertensive cases who presented with metabolic alkalosis and/or hypokalaemia. The two common causes of secondary hypertension, namely primary aldosteronism (PA) and renovascular disease, are presented in this case series. Conclusion: Diagnosis of secondary cause of hypertension such as primary aldosteronism or renovascular disease leads to targeted anti-hypertensive therapy resulting in better patient management.
Keywords : Aldosterone, Alkalosis, Antihypertensive Agents, Hypertension, Hypokalaemia, Renin.
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