High Prevalence of Thyroid Ultrasonographic Abnormalities in Primary Aldosteronism

Endocrine ◽  
2003 ◽  
Vol 22 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Decio Armanini ◽  
Davide Nacamulli ◽  
Carla Scaroni ◽  
Franco Lumachi ◽  
Riccardo Selice ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
High Prevalence

scholarly journals The Adrenal Gland: Central Relay in Health and Disease

2019 ◽  
Vol 127 (02/03) ◽  
pp. 81-83 ◽  
Author(s):  
Martin Reincke ◽  
Felix Beuschlein ◽  
Stefan Bornstein ◽  
Graeme Eisenhofer ◽  
Martin Fassnacht ◽  
...  
Keyword(s):  
Health Care ◽  
General Practitioner ◽  
Early Detection ◽  
Adrenal Gland ◽  
Primary Aldosteronism ◽  
High Morbidity ◽  
Adrenal Incidentalomas ◽  
Appropriate Treatment ◽  
High Prevalence ◽  
Health And Disease

Diseases of the adrenal gland are as important for the general practitioner as for the endocrine specialist. The high prevalence of some adrenal endocrinopathies, such as adrenal incidentalomas (1–2% of the population) and primary aldosteronism (6% of hypertensives), which affect millions of patients, makes adrenal diseases a relevant health issue. The high morbidity and mortality of some of the rarer adrenal diseases, i. e., Addison’s disease and Cushing’s syndrome (Table 1), make early detection and appropriate treatment such a challenge for the health care system.

High prevalence and a long delay in the diagnosis of primary aldosteronism among patients with young‐onset hypertension

2021 ◽  
Author(s):  
Sarah Alam ◽  
Devasenathipathy Kandasamy ◽  
Alpesh Goyal ◽  
Sreenivas Vishnubhatla ◽  
Sandeep Singh ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Young Onset ◽  
High Prevalence

scholarly journals High prevalence of primary aldosteronism in the Tayside hypertension clinic population

2000 ◽  
Vol 14 (5) ◽  
pp. 311-315 ◽  
Author(s):  
PO Lim ◽  
E Dow ◽  
G Brennan ◽  
RT Jung ◽  
TM MacDonald
Keyword(s):  
Primary Aldosteronism ◽  
Hypertension Clinic ◽  
High Prevalence ◽  
Clinic Population

Potentially high prevalence of primary aldosteronism in a primary-care population

The Lancet ◽  
1999 ◽  
Vol 353 (9146) ◽  
pp. 40 ◽  
Author(s):  
Pitt O Lim ◽  
Paula Rodgers ◽  
Kate Cardale ◽  
Alexander D Watson ◽  
Thomas M MacDonald
Keyword(s):  
Primary Care ◽  
Primary Aldosteronism ◽  
Primary Care Population ◽  
High Prevalence

scholarly journals Rates of Primary Aldosteronism Screening Among High-Risk Populations

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A297-A298
Author(s):  
Seda Grigoryan ◽  
Sonja Marie Konzen ◽  
Adina F Turcu
Keyword(s):  
High Risk ◽  
Primary Aldosteronism ◽  
Secondary Hypertension ◽  
White Americans ◽  
General Internists ◽  
Obstructive Sleep ◽  
High Prevalence ◽  
High Risk Populations ◽  
At Risk Populations ◽  
Adrenal Masses

Abstract Background: Primary aldosteronism (PA) is the most common form of secondary hypertension. PA is associated with higher cardiovascular and renal morbidity and mortality than equivalent essential hypertension. Data on PA screening rates are scarce. Objective: To evaluate the rates of PA screening among at-risk populations. Methods: We conducted a retrospective review of adult patients (age ≥ 18 years) with hypertension (HTN) seen in a University setting outpatient clinics between 2010–2019 who had: 1) resistant HTN; 2) HTN and hypokalemia; 3) HTN at age <40; 4) HTN and known adrenal mass; or 5) HTN and obstructive sleep apnea (OSA). We excluded patients with known high-renin HTN, renovascular HTN, or congenital adrenal hyperplasia. Results: We identified 11,627 patients with HTN meeting at least one of the inclusion criteria. Of these, only 3.27% were ever screened for PA. Patients screened were younger (47.5 ± 17.8 vs. 51.3 ±16.9, p <0.0001), more often women (55.28% vs. 45.71%, p=0.0003), had lower serum K+ (3.4 ± 0.5 vs. 3.7 ± 0.4, p<0.0001), and were more likely to have chronic kidney disease (29.27% vs. 17.5%, p<0.0001) and cerebrovascular accidents (9.21% vs. 6.16%, p= 0.02) than those never screened. While most patients in this cohort were white (79.9% vs. 15.3% black, and 2.3% Asian), screening rates were overall higher in Asian (8.4%) and black (6.1%) than in white Americans (2.8%, p<0.0001). Of the different indications for PA screening, the rates were highest among patients with adrenal nodules (35%) and lowest in patients with HTN and OSA (2.1%). The rates of screening were similar in patients younger vs. older than age 40 (3.2%, p=0.9). Among patients with resistant hypertension, those screened were on average 10 years younger (58.5 ± 14.0 vs. 68.7 ± 12.8, p<0.0001) and twice as often black (20.7% vs. 10.1%) compared to those not screened for PA. Conversely, in patients with adrenal masses, there were no sex, age, or race differences between those screened vs. not screened for PA. PA screening was initiated most often by general internists (53.9%), followed by endocrinologists (15.8%), and rarely by nephrologists (9.5%), or cardiologists (4.2%). Conclusions: Despite its high prevalence and associated cardio-renal morbidity, PA screening is pursued in only 3% of high-risk populations. While patients screened are generally younger and more often black than those not screened, the diagnosis is often suspected after complications have already developed. These data indicate that initiatives to encourage PA screening are crucial for preventing cardiovascular and renal morbidity in many patients with HTN.

scholarly journals Progress in Primary Aldosteronism 2019: New Players on the Block?

2020 ◽  
Vol 52 (06) ◽  
pp. 345-346 ◽  
Author(s):  
Martin Reincke ◽  
Felix Beuschlein ◽  
Tracy Ann Williams
Keyword(s):  
Resistant Hypertension ◽  
Primary Aldosteronism ◽  
Retrospective Cohort ◽  
Plasma Renin ◽  
Epidemiological Data ◽  
Screening Rate ◽  
Aldosterone Secretion ◽  
Endocrine Hypertension ◽  
High Prevalence ◽  
Aldosterone To Renin Ratio

Primary aldosteronism (PA) is characterized by hypertension caused by inappropriately high adrenal aldosterone secretion, consecutively low plasma renin, and an elevated aldosterone to renin ratio. It is nowadays the universally accepted main cause of endocrine hypertension. According to the most recent epidemiological data, PA is present in 5.8% of unselected hypertensives in primary care, 6–12% of hypertensives treated in hypertension centers, and up to 30% in subjects with resistant hypertension 1. Despite this high prevalence, a recent survey demonstrated that screening for PA is not universally followed. Renin and aldosterone measurements, the basis for PA screening, are currently performed by only 7% of general practitioners in Italy and 8% in Germany 2. Accordingly, the prevalence of PA was low with 1% among hypertensives in Italy and 2% in Germany. In a retrospective cohort study of 4660 patients with resistant hypertension in California the screening rate for PA was 2.1% 3. Based on these data, it is clear that we still miss the majority of PA cases, despite advances in diagnosis and therapy.

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