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Journal of the Bahrain Medical Society
Year 2026, Volume 38, Issue 1, Pages 18-25
https://doi.org/10.26715/jbms.38_1_2Dana Arekat1*, Reem AlSherooqi1, Suha Hejres2, Rehab Helmey2, Nitya Kumar3, Denis Quill4, John
G Flood1
1Department of Medicine in Royal College of Surgeons in Ireland-Medical University of Bahrain
2Department of Pathology, Blood Bank, and Laboratory Medicine in King Hamad University Hospital
3Department of Public Health and Epidemiology in Royal College of Surgeons in Ireland-Medical University of Bahrain
4Department of Surgery in Royal College of Surgeons in Ireland-Medical University of Bahrain
*Corresponding author:
Dr. Dana Zaid Arekat, Clinical Educator at RCSI Bahrain, Department of Medicine in Royal College of
Surgeons in Ireland-Medical University of Bahrain. E-mail: DArekat@rcsi.com
Received date: January 15, 2026; Accepted date: March 30, 2026; Published date: March 31, 2026
Abstract
Background: Primary hyperaldosteronism is a significant but often overlooked cause of secondary hypertension. It is characterized by excessive aldosterone production by the adrenal glands. A considerable gap exists in the prevalence of primary hyperaldosteronism, its diagnosis, and management, particularly in regions like the Middle East.
Methods: A Retrospective observational study of 158 patients who were screened for primary hyperaldosteronism between 2022 and 2023 was conducted. Access to their E-Files was granted by King Hamad University Hospital.
Results: All the patients underwent laboratory & clinical investigations to rule out secondary causes of hypertension. Elevated renin: aldosterone ratio was observed in 41 (26.8%), with 17 (11%) confirmed cases of primary hyperaldosteronism. Nine were males, eight were females, and all were Bahraini except one. Imaging showed hyperplasia in five cases, eight adenomas, and two patients did not have documented imaging done. Two of the patients had morphologically normal adrenals on imaging. Out of the eight cases with adenoma, six had bilateral disease, and two had unilateral. Of the seventeen patients, fourteen were treated with mineralocorticoid receptor antagonists, resulting in an increase in potassium levels (from 1.7-3.9 to 3.1-5.4 mmol/L) and a decrease in blood pressure (128/78-180/100 to 116/79-50/78 mmHg) post-treatment.
Conclusion: The incidence and prevalence of primary hyperaldosteronism in the Kingdom of Bahrain remain an area of active research. The available data highlights the potential underdiagnosis of primary hyperaldosteronism in this region, necessitating further comprehensive studies.
Keywords: Primary hyperaldosteronism, Renin, Aldosterone, Hypertension, Potassium