Who needs to be screened for primary aldosteronism?
The prevalence of patients with primary aldosteronism (PA) is about 5%–15% in hypertensive patients, and it is common cause of secondary hypertension in clinical practice. Two major causes of PA are noted, namely bilateral adrenal hyperplasia and aldosterone-producing adenoma, and the general diagno...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664623003352 |
| _version_ | 1797267213515751424 |
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| author | Wei-Chieh Huang Feng-Hsuan Liu Hao-Min Cheng Yi-Chun Tsai Yen-Ta Huang Tai-Shuan Lai Yen-Hung Lin Vin-Cent Wu Hsien-Li Kao Charles Jia-Yin Hou Kwan-Dun Wu Szu-Tah Chen Leay Kiaw Er |
| author_facet | Wei-Chieh Huang Feng-Hsuan Liu Hao-Min Cheng Yi-Chun Tsai Yen-Ta Huang Tai-Shuan Lai Yen-Hung Lin Vin-Cent Wu Hsien-Li Kao Charles Jia-Yin Hou Kwan-Dun Wu Szu-Tah Chen Leay Kiaw Er |
| author_sort | Wei-Chieh Huang |
| collection | DOAJ |
| description | The prevalence of patients with primary aldosteronism (PA) is about 5%–15% in hypertensive patients, and it is common cause of secondary hypertension in clinical practice. Two major causes of PA are noted, namely bilateral adrenal hyperplasia and aldosterone-producing adenoma, and the general diagnosis is based on three steps: (1) screening, (2) confirmatory testing, and (3) subtype differentiation (Figure 1). The recommendation for screening patients is at an increased risk of PA, here we focus on which patients should be screened for PA, not only according to well-established guidelines but for potential patients with PA. We recommend screening for 1) patients with resistant or persistent hypertension, 2) hypertensive patients with hypokalemia (spontaneous or drug-induced), 3) young hypertensive patients (age <40 years), and 4) all hypertensive patients with a history of PA in first-degree relatives. Moreover, we suggest screening for 1) hypertensive patients themselves or first-degree relatives with early target organ damage, such as stroke and other diseases, 2) all hypertensive patients with a concurrent adrenal incidentaloma, 3) hypertensive patients with obstructive sleep apnea, 4) hypertensive patients with atrial fibrillation unexplained by structural heart defects and/or other conditions resulting in the arrhythmia, 5) hypertensive patients with anxiety and other psychosomatic symptoms, and 6) hypertensive patients without other comorbidities to maintain cost-effectiveness. |
| first_indexed | 2024-04-25T01:13:01Z |
| format | Article |
| id | doaj.art-d78dcd7b9dc6416dba6465b8c7d3c607 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-04-25T01:13:01Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-d78dcd7b9dc6416dba6465b8c7d3c6072024-03-10T05:11:22ZengElsevierJournal of the Formosan Medical Association0929-66462024-03-01123S82S90Who needs to be screened for primary aldosteronism?Wei-Chieh Huang0Feng-Hsuan Liu1Hao-Min Cheng2Yi-Chun Tsai3Yen-Ta Huang4Tai-Shuan Lai5Yen-Hung Lin6Vin-Cent Wu7Hsien-Li Kao8Charles Jia-Yin Hou9Kwan-Dun Wu10Szu-Tah Chen11Leay Kiaw Er12Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, New Taipei City Hospital, New Taipei City, TaiwanDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, TaiwanInstitute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Center for Evidence-based Medicine, Taipei Veterans General Hospital, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical, Taiwan; University Hospital, Kaohsiung University Hospital, Kaohsiung, TaiwanDepartment of Surgery, National Cheng Kung University Hospital, Taiwan; College of Medicine, National Cheng Kung University, Tainan, TaiwanDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Primary Aldosteronism Center at National Taiwan University Hospital, Taipei, TaiwanPrimary Aldosteronism Center at National Taiwan University Hospital, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Primary Aldosteronism Center at National Taiwan University Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanCardiovascular Center, MacKay Memorial Hospital, Taipei, TaiwanPrimary Aldosteronism Center at National Taiwan University Hospital, Taipei, TaiwanDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, TaiwanThe Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan; Corresponding author. The Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.The prevalence of patients with primary aldosteronism (PA) is about 5%–15% in hypertensive patients, and it is common cause of secondary hypertension in clinical practice. Two major causes of PA are noted, namely bilateral adrenal hyperplasia and aldosterone-producing adenoma, and the general diagnosis is based on three steps: (1) screening, (2) confirmatory testing, and (3) subtype differentiation (Figure 1). The recommendation for screening patients is at an increased risk of PA, here we focus on which patients should be screened for PA, not only according to well-established guidelines but for potential patients with PA. We recommend screening for 1) patients with resistant or persistent hypertension, 2) hypertensive patients with hypokalemia (spontaneous or drug-induced), 3) young hypertensive patients (age <40 years), and 4) all hypertensive patients with a history of PA in first-degree relatives. Moreover, we suggest screening for 1) hypertensive patients themselves or first-degree relatives with early target organ damage, such as stroke and other diseases, 2) all hypertensive patients with a concurrent adrenal incidentaloma, 3) hypertensive patients with obstructive sleep apnea, 4) hypertensive patients with atrial fibrillation unexplained by structural heart defects and/or other conditions resulting in the arrhythmia, 5) hypertensive patients with anxiety and other psychosomatic symptoms, and 6) hypertensive patients without other comorbidities to maintain cost-effectiveness.http://www.sciencedirect.com/science/article/pii/S0929664623003352Primary aldosteronismHypertensionAldosterone renin ratioScreen |
| spellingShingle | Wei-Chieh Huang Feng-Hsuan Liu Hao-Min Cheng Yi-Chun Tsai Yen-Ta Huang Tai-Shuan Lai Yen-Hung Lin Vin-Cent Wu Hsien-Li Kao Charles Jia-Yin Hou Kwan-Dun Wu Szu-Tah Chen Leay Kiaw Er Who needs to be screened for primary aldosteronism? Journal of the Formosan Medical Association Primary aldosteronism Hypertension Aldosterone renin ratio Screen |
| title | Who needs to be screened for primary aldosteronism? |
| title_full | Who needs to be screened for primary aldosteronism? |
| title_fullStr | Who needs to be screened for primary aldosteronism? |
| title_full_unstemmed | Who needs to be screened for primary aldosteronism? |
| title_short | Who needs to be screened for primary aldosteronism? |
| title_sort | who needs to be screened for primary aldosteronism |
| topic | Primary aldosteronism Hypertension Aldosterone renin ratio Screen |
| url | http://www.sciencedirect.com/science/article/pii/S0929664623003352 |
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