Comparison of comorbidity incidences between hypokalemia and normokalemia primary aldosteronism patients

Little information is available on apparent differences in comorbidities between hypokalemia and normokalemia in primary aldosteronism (PA) patients. Our study aimed to evaluate the differences regarding comorbidities of PA patients with different serum potassium levels. A total of 629 PA patients were enrolled and divided into hypokalemic and normokalemic types of PA. The general clinical characteristics and related biochemical parameters were collected in all subjects. The incidences of different comorbidities in hypokalemia and normokalemia PA patients were analyzed. Of the 629 patients (49.86 ± 11.66 years, range 18–79), 26.9% had hypokalemic PA. The systolic blood pressures (158.43 ± 2.35 vs. 150.84 ± 21.57 mmHg; P  < 0.001), diastolic blood pressures (96.57 ± 15.51 vs. 91.98 ± 15.77 mmHg; P  < 0.05) and plasma aldosterone concentration ( P  < 0.001) were significantly higher in hypokalemic PA patients than those in normokalemic PA patients. The hypokalemic PA patients had higher urinary microalbumin than normokalemic PA patients ( P  < 0.05). There was a negative correlation between serum potassium level and level of orthostatic aldosterone concentration and systolic blood pressure, The incidences of obstructive sleep apnea were higher in hypokalemic than those in normokalemic PA patients ( P  < 0.05). Our data suggest that high prevalence of comorbidities presented in patients with PA. The hypokalemic PA patients had higher incidence of obstructive sleep apnea than the normokalemic PA patients. Therefore, PA's early diagnosis and treatment, especially for the patients with hypokalemic PA, are essential.