Prevalence of Anxiety Disorder in Primary Hyperaldosteronism and Its Association with Treatment Modality

Abstract

Objective: The aims of this study were to determine the prevalence of anxiety disorder in patients with primary hyperaldosteronism (PA), to compare it with patients diagnosed with essential hypertension (EHT) after exclusion of secondary causes, and to evaluate the association between treatment modalities for PA and changes in the course of anxiety disorder.
Methods: A total of 133 patients were included in this retrospective study, comprising 90 patients with PA and 43 patients with EHT. Among patients with PA, 39 received surgical treatment and 51 received medical therapy. The PA and EHT groups were compared with respect to demographic, clinical, and laboratory characteristics. Within the PA group, the relationship between treatment modality and changes in anxiety disorder management during follow-up was also analyzed.
Results: The prevalence of anxiety disorder was significantly higher in the PA group compared with the EHT group (27.8% vs. 9.3%, p = 0.029). Patients with PA were younger and more frequently male. Serum aldosterone levels and the aldosterone-to-renin ratio were significantly higher, whereas renin and potassium levels were significantly lower in the PA group (all p < 0.05). Among patients with PA, no significant differences were observed in most clinical and laboratory parameters between those with and without anxiety disorder. Discontinuation of anxiety disorder treatment was observed more frequently in patients who underwent surgical treatment compared with those receiving medical therapy.
Conclusions: These findings suggest that anxiety disorder accompanying hypertension may be more frequently observed in patients with PA and that there may be an association between treatment modality and psychiatric outcomes.

Keywords

• Primary hyperaldosteronism
• Anxiety disorder
• Essential hypertension
• Adrenalectomy

Ethical Statement

The study protocol was approved by the Necmettin Erbakan University Ethics Committee for Non-Interventional Clinical Research (date: January 10, 2025; decision no: 2025/5449). Due to the retrospective design of the study, informed consent was not obtained from the patients.

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