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The Prevalence of Adrenal Cortical Hyperplasia at Autopsy and Its Association with Hypertension

R. PATTERSON RUSSELL, M.D., F.A.C.P.; and ALFONSE T. MASI, M.D., F.A.C.P.
[+] Article and Author Information

Supported in part by grants from the Heart Association of Maryland, Baltimore, and the Tennessee Heart Association, Memphis; and by grant AM-5055, U. S. Public Health Service, Washington, D.C.

Presented in part March 4, 1969, at the Conference on Cardiovascular Disease Epidemiology, New Orleans, La.

▸Requests for reprints should be addressed to R. Patterson Russell, M.D., Johns Hopkins Hospital, Baltimore, Md. 21205


Baltimore, Maryland


Ann Intern Med. 1970;73(2):195-205. doi:10.7326/0003-4819-73-2-195
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Review of the autopsy indexes of the Johns Hopkins Hospital, Baltimore, Md., between 1889 and 1966 provided 180 cases of adrenal cortical hyperplasia among 35,000 examinations (0.51%). The total prevalence of adrenal cortical hyperplasia at autopsy increased with age, and the age-adjusted prevalence among negro males exceeded (P < 0.05) that of the other race-sex groups. A highly significant excess (P < 0.001) of all forms of hypertension was found in the cases compared with carefully matched controls. Males tended to contribute more significantly (P < 0.01) than females (P < 0.025) to the excess. An excess of essential hypertension significant at the 5% probability level was found in the total case series. Further analyses by race of cases and controls showed that recognized secondary forms of hypertension correlated significantly (P < 0.025) with the cases in whites; whereas "essential" accelerated hypertension correlated significantly (P < 0.025) with the cases in negroes. Unequivocally documented Cushing's syndrome was found in seven of the cases and in none of the controls (P < 0.025). The excess of essential and essential-accelerated hypertension among the cases could not be accounted for by the presence of nonbasophilic pituitary adenomas, use of benzothiadiazine diuretics, concommitant renal disease, or carcinomatosis.

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