Draft abstract still updating information.

March 31, 2012

we are limited to 250 words in the abstract itself. Going to bed.

Draft: Delayed Diagnosis of Primary

Aldosteronism-help from the Web: a support group for patients struggling

with diagnosis and long-term management. Grim CE, Hall S,

V and the 500+ members of hyperaldosteronism

at Background: Primary

aldosteronism (PA) presents as drug resistant hypertension (DRHTN) and a diffuse/confusing

symptom complex as hypokalemia(LoK) evolves. Laboratory testing(DX) has revolutionized the practitioner’s

ability to Dx/treat/refer/improve lives in PA but many are missed as PA is thought

to be rare. Methods: An online

support group was organized in 2002 by a patient with the myriad problems

associated with PA(soon joined by Dr. Grim who serves as the medical consultant).

Over 500+ PAs contribute support/education

to new suspected/DXed patients (most with advanced PA). Detailed information

was contributed by 88 (48% men) from 11 nations. Results: Age XX, adenoma(s):unilateral(XX)/bilateral(XX),

hyperplasia(21). Drs seen before Dx=5±X(range1-15), uncontrolled HTN=10

yrs(1-40), LoK=5(0-58)yrs. BP decreased from 208±35/122±24

mmHg before DX to 128±15/78±15 after surgical(XX) or medical Rx(XX). Spironolactone Rx=xx, eplerenone xx

mg/d). Symptoms: DRHTN(93%), fatigue=75%,

nocturia=75%), muscle cramps(XX%), multiple ER visits for complex of headaches,

chest pains, muscle cramps, and anxiety (including what many refer to as

“mental fog”) and finding of severe HTN and LoK (90%). RX: A LoNa/HiK(DASH) diet is a powerful

adjunct to Rx in PA but only 14% was this recommended. Stressing DASH has led to dramatic improvement

in HTN, Sx, and need for BP Rx. Conclusions: Dx of PA is often missed as documented in

this web support group. We invite all

who care for difficult HTN to to read the files on “Conn's

Stories” as we are certain they will recognize some of their own patients and

be spurred to Dx and Rx PA.

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