CMAJ ARTICLE ON PRIMARY ALDOSTERONISM (CONN SYNDROME) -- PREVALENCE UP TO 10 PER CENT OF RESISTANT HYPERTENSIVES.

A FEW YEARS AGO, A TORONTO LECTURE BY MELBOURNE PRINCE HENRY HOSP PROFESSOR  JOHN FUNDER AC MD PHD FRCP FRACP CHANGED DIAGNOSTIC POLICY IN ONTARIO. CARDIOLOGISTS, ENDOCRINOLOGISTS, NEPHROLOGISTS, NEUROLOGISTS AND  UROLOGISTS,  STARTED LOOKING FOR CONN, CARCINOID AND PHAEOCHROMOCYTOMA, (CCP) AFTER PROFESSOR FUNDER STATED THAT ABOUT 10 PER CENT OF RESISTANT HYPERTENSIVES HAVE CONN SYNDROME.  AS EARLY AS 1959 IN LONDON,UK IT WAS OBLIGATORY TO LOOK FOR THE CCP TRIAD IN EVERY HYPERTENSIVE PATIENT  AND NOT JUST TREAT THE BP WITHOUT A PRECISE DIAGNOSIS.      JFUNDER@UQ.EDU.AU                                                                                                                                                                             

"ISABEL" DIAGNOSTIC PROGRAM NOW CAN GIVE RESULTS  IN SECONDS AFTER ENTERING RESISTANT HYPERTENSION, PALPITATIONS, AND NOCTURNAL POLYURIA.- A SYMPTOM AND SIGN OMITTED COMPLETELY IN THE CMAJ PAPER.

SIMPLE GP TEST FOR CONN SYNDROME  IS TO GIVE ALDACTONE. BP FALLS DRAMATICALLY.    

INVESTIGATIONS INCLUDE  POTASSIUM,  ALDOSTERONE, RENIN,  DIAGNOSTIC RADIOLOGY AND ADRENAL VEIN SAMPLING,    REMOVAL OF THE ADRENAL BY ENDOSCOPY CAN CURE THE HYPERTENSION.COMPLETELY.

 (COMMENTS BY DR A FRANKLIN WHO ATTENDED PROF FUNDER'S LECTURE)

DELAY IN DIAGNOSIS ,OFTEN FOR YEARS, IS ASSOCIATED WITH PRESENT SOCIALIST POLICY OF NOT ADMITTING PATIENTS FOR DIAGNOSTIC INVESTIGATION.  ALDOSTERONE AND RENIN BEST TESTED AFTER A NIGHT'S REST AND BEFORE GETTING OUT OF BED.  IN TORONTO, PRIVATE LABS WEILL DO HOUSE CALLS FOR A MODEST $30 BUT MOST DOCS ARE FRIGHTENED TO EVEN TELL PATIENTS ABOUT THIS SERVICE AS THE MAJORITY HAVE BEEN SOCIALLY ENGINEERED TO BELIEVE THAT ALL MEDICINE MUST BE FREE IN A WELFARE STATE. THE PATIENT COULD MAKE A COMPLAINT TO THE ONT  COLLEGE OF PHYS AND SURGEONS LEADING TO A TIME WASTING INVESTIGATION OF MALPRACTICE.