The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism

doi:10.1016/j.ijchy.2020.100029

Review

. 2020 Apr 15:5:100029.

doi: 10.1016/j.ijchy.2020.100029. eCollection 2020 Jun.

The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism

Gian Paolo Rossi¹, Valeria Bisogni¹, Alessandra Violet Bacca², Anna Belfiore³, Maurizio Cesari¹, Antonio Concistrè⁴, Rita Del Pinto⁵, Bruno Fabris⁶, Francesco Fallo⁷, Cristiano Fava⁸, Claudio Ferri⁵, Gilberta Giacchetti⁹, Guido Grassi¹⁰, Claudio Letizia⁴, Mauro Maccario¹¹, Francesca Mallamaci¹², Giuseppe Maiolino¹, Dario Manfellotto¹³, Pietro Minuz⁸, Silvia Monticone¹⁴, Alberto Morganti¹⁵, Maria Lorenza Muiesan¹⁶, Paolo Mulatero¹⁴, Aurelio Negro¹⁷, Gianfranco Parati¹⁸, Martino F Pengo¹⁸, Luigi Petramala⁴, Francesca Pizzolo⁸, Damiano Rizzoni¹⁶, Giacomo Rossitto^{1

19}, Franco Veglio¹⁴, Teresa Maria Seccia¹

Affiliations

¹ Clinica dell'Ipertensione Arteriosa, Department of Medicine - DIMED, University of Padua, Italy.
² Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
³ Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy.
⁴ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Italy.
⁵ University of L'Aquila, Department of Life, Health and Environmental Sciences, San Salvatore Hospital, L'Aquila, Italy.
⁶ Department of Medical Sciences, Università degli Studi di Trieste, Cattinara Teaching Hospital, Trieste, Italy.
⁷ Department of Medicine, DIMED, Internal Medicine 3, University of Padua, Italy.
⁸ Department of Medicine, University of Verona, Policlinico "G.B. Rossi", Italy.
⁹ Division of Endocrinology, Polytechnic University of Marche, Ancona, Italy.
¹⁰ University of Milano-Bicocca, Italy.
¹¹ Endocrinology, Diabetology, and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy.
¹² CNR-IFC Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Calabria, Italy.
¹³ UO Medicina Interna, Ospedale Fatebenefratelli Isola Tiberina, Rome, Italy.
¹⁴ Hypertension Unit, Division of Internal Medicine, Department of Medical Sciences, University of Turin, Italy.
¹⁵ Centro Fisiologia Clinica e Ipertensione, Ospedale Policlinico, Università Milano, Milan, Italy.
¹⁶ Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
¹⁷ Department of Medicine, Center for Hypertension, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy.
¹⁸ Department of Medicine and Surgery, University of Milano-Bicocca and Istituto Auxologico Italiano, IRCCS, Milan, Italy.
¹⁹ University of Glasgow, Institute of Cardiovascular and Medical Sciences, Glasgow, UK.

PMID: 33447758
PMCID: PMC7803025
DOI: 10.1016/j.ijchy.2020.100029

Free PMC article

Review

The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism

Gian Paolo Rossi et al. Int J Cardiol Hypertens. 2020.

Free PMC article

. 2020 Apr 15:5:100029.

doi: 10.1016/j.ijchy.2020.100029. eCollection 2020 Jun.

Authors

Affiliations

¹ Clinica dell'Ipertensione Arteriosa, Department of Medicine - DIMED, University of Padua, Italy.
² Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
³ Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy.
⁴ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Italy.
⁵ University of L'Aquila, Department of Life, Health and Environmental Sciences, San Salvatore Hospital, L'Aquila, Italy.
⁶ Department of Medical Sciences, Università degli Studi di Trieste, Cattinara Teaching Hospital, Trieste, Italy.
⁷ Department of Medicine, DIMED, Internal Medicine 3, University of Padua, Italy.
⁸ Department of Medicine, University of Verona, Policlinico "G.B. Rossi", Italy.
⁹ Division of Endocrinology, Polytechnic University of Marche, Ancona, Italy.
¹⁰ University of Milano-Bicocca, Italy.
¹¹ Endocrinology, Diabetology, and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy.
¹² CNR-IFC Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Calabria, Italy.
¹³ UO Medicina Interna, Ospedale Fatebenefratelli Isola Tiberina, Rome, Italy.
¹⁴ Hypertension Unit, Division of Internal Medicine, Department of Medical Sciences, University of Turin, Italy.
¹⁵ Centro Fisiologia Clinica e Ipertensione, Ospedale Policlinico, Università Milano, Milan, Italy.
¹⁶ Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
¹⁷ Department of Medicine, Center for Hypertension, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy.
¹⁸ Department of Medicine and Surgery, University of Milano-Bicocca and Istituto Auxologico Italiano, IRCCS, Milan, Italy.
¹⁹ University of Glasgow, Institute of Cardiovascular and Medical Sciences, Glasgow, UK.

PMID: 33447758
PMCID: PMC7803025
DOI: 10.1016/j.ijchy.2020.100029

Abstract

Background and aim: Considering the amount of novel knowledge generated in the last five years, a team of experienced hypertensionlogists was assembled to furnish updated clinical practice guidelines for the management of primary aldosteronism.

Methods: To identify the most relevant studies, the authors utilized a systematic literature review in international databases by applying the PICO strategy, and then they were required to make use of only those meeting predefined quality criteria. For studies of diagnostic tests, only those that fulfilled the Standards for Reporting of Diagnostic Accuracy recommendations were considered.

Results: Each section was jointly prepared by at least two co-authors, who provided Class of Recommendation and Level of Evidence following the American Heart Association methodology. The guidelines were sponsored by the Italian Society of Arterial Hypertension and underwent two rounds of revision, eventually reexamined by an External Committee. They were presented and thoroughly discussed in two face-to-face meetings with all co-authors and then presented on occasion of the 36th Italian Society of Arterial Hypertension meeting in order to gather further feedbacks by all members. The text amended according to these feedbacks was subjected to a further peer review.

Conclusions: After this process, substantial updated information was generated, which could simplify the diagnosis of primary aldosteronism and assist practicing physicians in optimizing treatment and follow-up of patients with one of the most common curable causes of arterial hypertension.

Keywords: Diagnosis; Guidelines; Hypertension; Primary aldosteronism; Treatment.

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Conflict of interest statement

None.

Figures

**Fig. 1**
Main steps followed in the preparation of the Guidelines.

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References

1. Funder J.W., Carey R.M., Mantero F. The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 2016;101:1889–1916. - PubMed
1. Carey R.M., Whelton P.K. Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American college of cardiology/American heart association hypertension guideline. Ann. Intern. Med. 2018;168:351–358. - PubMed
1. da Costa Santos C.M., de Mattos Pimenta C.A., Nobre M.R. The PICO strategy for the research question construction and evidence search. Rev. Lat. Am. Enfermagem. 2007;15:508–511. - PubMed
1. Halperin J.L., Levine G.N., Al-Khatib S.M. Further evolution of the ACC/AHA clinical practice guideline recommendation classification system: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. J. Am. Coll. Cardiol. 2016;67:1572–1574. - PubMed
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[1] Funder J.W., Carey R.M., Mantero F. The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 2016;101:1889–1916. - PubMed

[2] Funder J.W., Carey R.M., Mantero F. The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 2016;101:1889–1916. - PubMed

[3] Carey R.M., Whelton P.K. Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American college of cardiology/American heart association hypertension guideline. Ann. Intern. Med. 2018;168:351–358. - PubMed

[4] Carey R.M., Whelton P.K. Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American college of cardiology/American heart association hypertension guideline. Ann. Intern. Med. 2018;168:351–358. - PubMed

[5] da Costa Santos C.M., de Mattos Pimenta C.A., Nobre M.R. The PICO strategy for the research question construction and evidence search. Rev. Lat. Am. Enfermagem. 2007;15:508–511. - PubMed

[6] da Costa Santos C.M., de Mattos Pimenta C.A., Nobre M.R. The PICO strategy for the research question construction and evidence search. Rev. Lat. Am. Enfermagem. 2007;15:508–511. - PubMed

[7] Halperin J.L., Levine G.N., Al-Khatib S.M. Further evolution of the ACC/AHA clinical practice guideline recommendation classification system: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. J. Am. Coll. Cardiol. 2016;67:1572–1574. - PubMed

[8] Halperin J.L., Levine G.N., Al-Khatib S.M. Further evolution of the ACC/AHA clinical practice guideline recommendation classification system: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. J. Am. Coll. Cardiol. 2016;67:1572–1574. - PubMed

[9] Bossuyt P.M., Reitsma J.B., Bruns D.E., for the STARD Group Stard 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ. 2015;351:h5527. - PMC - PubMed

[10] Bossuyt P.M., Reitsma J.B., Bruns D.E., for the STARD Group Stard 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ. 2015;351:h5527. - PMC - PubMed

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The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism

Affiliations

The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism

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