Current pattern of primary aldosteronism diagnosis: Delayed and complicated

Aust J Gen Pract. 2018 Oct;47(10):712-718. doi: 10.31128/AJGP-05-18-4587.

Abstract

Background: Primary aldosteronism is the most common specifically treatable and potentially curable cause of hypertension.

Objective: The aim of this study was to analyse the referral pattern and disease characteristics of patients with hypertension and suspected primary aldosteronism.

Methods: We prospectively collected clinical data from patients who attended the Endocrine Hypertension Service (EHS) at Monash Health from May 2016 to May 2017.

Results: Of 87 patients, 69.2% had indications for primary aldosteronism screening in the primary care setting, although only 3.7% were actually screened. At the time of referral to the EHS, 61% had hypertension for over 10 years and 42% of the patients with primary aldosteronism had associated end-organ damage. Targeted treatment of primary aldosteronism led to biochemical and clinical improvement in all patients.

Discussion: The diagnosis of primary aldosteronism is currently delayed and associated with significant end-organ damage. Increased awareness of primary aldosteronism and its screening indications in primary and tertiary care is needed for earlier diagnosis and improved outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use
  • Delayed Diagnosis / statistics & numerical data*
  • Female
  • Humans
  • Hyperaldosteronism / diagnosis*
  • Hyperaldosteronism / epidemiology
  • Male
  • Mass Screening / methods
  • Mass Screening / standards
  • Middle Aged
  • Primary Health Care / methods
  • Primary Health Care / standards
  • Primary Health Care / statistics & numerical data

Substances

  • Antihypertensive Agents