Extensive personal experience - Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents

Mulatero P.; Stowasser, M; Loh, KC; Fardella, CE; Gordon, RD; Mosso L.; Gomez-Sanchez, CE; Veglio, F; Young, WF

Abstract

Primary aldosteronism (PA) is a common form of endocrine hypertension previously believed to account for less than 1% of hypertensive patients. Hypokalemia was considered a prerequisite for pursuing diagnostic tests for PA. Recent studies applying the plasma aldosterone/plasma renin activity ratio (ARR) as a screening test have reported a higher prevalence. This study is a retrospective evaluation of the diagnosis of PA from clinical centers in five continents before and after the widespread use of the ARR as a screening test. The application of this strategy to a greater number of hypertensives led to a 5- to 15-fold increase in the identification of patients affected by PA. Only a small proportion of patients (between 9 and 37%) were hypokalemic. The annual detection rate of aldosterone-producing adenoma (APA) increased in all centers (by 1.3-6.3 times) after the wide application of ARR. Aldosterone-producing adenomas constituted a much higher proportion of patients with PA in the four centers that employed adrenal venous sampling (28-50%) than in the center that did not (9%). In conclusion, the wide use of the ARR as a screening test in hypertensive patients led to a marked increase in the detection rate of PA.

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Título según WOS: Extensive personal experience - Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents
Título según SCOPUS: Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents
Título de la Revista: JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volumen: 89
Número: 3
Editorial: ENDOCRINE SOC
Fecha de publicación: 2004
Página de inicio: 1045
Página final: 1050
Idioma: English
URL: http://press.endocrine.org/doi/abs/10.1210/jc.2003-031337
DOI:

10.1210/jc.2003-031337

Notas: ISI, SCOPUS