[Causes of delaying diagnosis of primary hyperaldosteronism with adrenal adenoma and strategy therefore].

Objective: To analyze the causes of delaying diagnosis of primary hyperaldosteronism with adrenal adenoma and discuss corrective strategies.

Methods: The clinical data of 267 patients of primary hyperaldosteronism with adrenal adenoma confirmed by operation 1995 - 2005 were analyzed.

Results: Confirmed diagnosis was made after a duration of (92 +/- 64) months (3 - 40 years) after the first visit. 78.3% of the hospitals where the patients with hypertension made their first visits were grade II hospitals, and 21.3% of them were grade III hospitals. 95.9% of the patients were diagnosed as with primary hypertension at the first visit without receiving relevant imaging examination of adrenal and endocrine examination. 87.3% of the patients with extremity weakness numbness of finger tips were diagnosed as with hypokalemia and more than 10% of them failed to receive examination of blood potassium. Adrenal adenoma was discovered by computed tomography with thin coat screening in 267 patients and by ultrasonography in 151 patients.

Conclusion: Primary hyperaldosteronism should be considered and screened in all young patients with hypertension. Plasma aldosterone/rennin ratio is an effective mark in screening. The first choice diagnostic means for primary hyperaldosteronism should be computed tomography with screening by coat 2 - 4 mm thin.