Who should be screened for primary aldosteronism? A comprehensive review of current evidence
Abstract Arterial hypertension is a major risk factor for cardiovascular disease. The prevalence of primary aldosteronism (PA) ranges from 5% to 10% in the general hypertensive population and is regarded as one of the most common causes of secondary hypertension. There are two major causes of PA: bi...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-09-01
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| Series: | The Journal of Clinical Hypertension |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jch.14558 |
| _version_ | 1797645176482562048 |
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| author | Wei‐Chieh Huang Yen‐Hung Lin Vin‐Cent Wu Chen‐Huan Chen Saulat Siddique Yook‐Chin Chia Jam Chin Tay Guruprasad Sogunuru Hao‐Min Cheng Kazuomi Kario |
| author_facet | Wei‐Chieh Huang Yen‐Hung Lin Vin‐Cent Wu Chen‐Huan Chen Saulat Siddique Yook‐Chin Chia Jam Chin Tay Guruprasad Sogunuru Hao‐Min Cheng Kazuomi Kario |
| author_sort | Wei‐Chieh Huang |
| collection | DOAJ |
| description | Abstract Arterial hypertension is a major risk factor for cardiovascular disease. The prevalence of primary aldosteronism (PA) ranges from 5% to 10% in the general hypertensive population and is regarded as one of the most common causes of secondary hypertension. There are two major causes of PA: bilateral adrenal hyperplasia and aldosterone‐producing adenoma. The diagnosis of PA comprises screening, confirmatory testing, and subtype differentiation. The Endocrine Society Practice Guidelines for the diagnosis and treatment of PA recommends screening of patients at an increased risk of PA. These categories include patients with stage 2 and 3 hypertension, drug‐resistant hypertension, hypertensive with spontaneous or diuretic‐induced hypokalemia, hypertension with adrenal incidentaloma, hypertensive with a family history of early onset hypertension or cerebrovascular accident at a young age, and all hypertensive first‐degree relatives of patients with PA. Recently, several studies have linked PA with obstructive sleep apnea and atrial fibrillation unexplained by structural heart defects and/or other conditions known to cause the arrhythmia, which may be partly responsible for the higher rates of cardiovascular and cerebrovascular accidents in patients with PA. The aim of this review is to discuss which patients should be screened for PA, focusing not only on well‐established guidelines but also on additional groups of patients with a potentially higher prevalence of PA, as has been reported in recent research. |
| first_indexed | 2024-03-11T14:42:36Z |
| format | Article |
| id | doaj.art-a0b37bc7145a48bc8163bf6e1b6f1f85 |
| institution | Directory Open Access Journal |
| issn | 1524-6175 1751-7176 |
| language | English |
| last_indexed | 2024-03-11T14:42:36Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Clinical Hypertension |
| spelling | doaj.art-a0b37bc7145a48bc8163bf6e1b6f1f852023-10-30T13:26:45ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762022-09-012491194120310.1111/jch.14558Who should be screened for primary aldosteronism? A comprehensive review of current evidenceWei‐Chieh Huang0Yen‐Hung Lin1Vin‐Cent Wu2Chen‐Huan Chen3Saulat Siddique4Yook‐Chin Chia5Jam Chin Tay6Guruprasad Sogunuru7Hao‐Min Cheng8Kazuomi Kario9Division of Cardiology Department of Internal Medicine Taipei Veterans General Hospital Taipei TaiwanDepartment of Internal Medicine National Taiwan University Hospital Taipei TaiwanDepartment of Internal Medicine National Taiwan University Hospital Taipei TaiwanDepartment of Internal Medicine National Yang Ming Chiao Tung University College of Medicine Taipei TaiwanPunjab Medical Center Lahore PakistanDepartment of Medical Sciences School of Medical and Life Sciences Sunway University Bandar Sunway MalaysiaDepartment of General Medicine Tan Tock Seng Hospital Singapore SingaporeDepartment of Cardiology College of Medical Sciences Kathmandu University Kathmandu NepalCenter for Evidence‐based Medicine Taipei Veterans General Hospital Taipei TaiwanDivision of Cardiovascular Medicine Department of Medicine Jichi Medical University School of Medicine Tochigi JapanAbstract Arterial hypertension is a major risk factor for cardiovascular disease. The prevalence of primary aldosteronism (PA) ranges from 5% to 10% in the general hypertensive population and is regarded as one of the most common causes of secondary hypertension. There are two major causes of PA: bilateral adrenal hyperplasia and aldosterone‐producing adenoma. The diagnosis of PA comprises screening, confirmatory testing, and subtype differentiation. The Endocrine Society Practice Guidelines for the diagnosis and treatment of PA recommends screening of patients at an increased risk of PA. These categories include patients with stage 2 and 3 hypertension, drug‐resistant hypertension, hypertensive with spontaneous or diuretic‐induced hypokalemia, hypertension with adrenal incidentaloma, hypertensive with a family history of early onset hypertension or cerebrovascular accident at a young age, and all hypertensive first‐degree relatives of patients with PA. Recently, several studies have linked PA with obstructive sleep apnea and atrial fibrillation unexplained by structural heart defects and/or other conditions known to cause the arrhythmia, which may be partly responsible for the higher rates of cardiovascular and cerebrovascular accidents in patients with PA. The aim of this review is to discuss which patients should be screened for PA, focusing not only on well‐established guidelines but also on additional groups of patients with a potentially higher prevalence of PA, as has been reported in recent research.https://doi.org/10.1111/jch.14558aldosterone renin ratiohypertensionprimary aldosteronismscreen |
| spellingShingle | Wei‐Chieh Huang Yen‐Hung Lin Vin‐Cent Wu Chen‐Huan Chen Saulat Siddique Yook‐Chin Chia Jam Chin Tay Guruprasad Sogunuru Hao‐Min Cheng Kazuomi Kario Who should be screened for primary aldosteronism? A comprehensive review of current evidence The Journal of Clinical Hypertension aldosterone renin ratio hypertension primary aldosteronism screen |
| title | Who should be screened for primary aldosteronism? A comprehensive review of current evidence |
| title_full | Who should be screened for primary aldosteronism? A comprehensive review of current evidence |
| title_fullStr | Who should be screened for primary aldosteronism? A comprehensive review of current evidence |
| title_full_unstemmed | Who should be screened for primary aldosteronism? A comprehensive review of current evidence |
| title_short | Who should be screened for primary aldosteronism? A comprehensive review of current evidence |
| title_sort | who should be screened for primary aldosteronism a comprehensive review of current evidence |
| topic | aldosterone renin ratio hypertension primary aldosteronism screen |
| url | https://doi.org/10.1111/jch.14558 |
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